ABSTRACT
INTRODUCTION: globally, the rate of maternal mortality is unacceptably high with Kenya recording a rate of 362 maternal death per 100,000 live births. Even so, only 62% of women deliver under skilled health care. The government of Kenya introduced Free Maternity Services (FMS) to all women delivering in public health facilities as a way of increasing facility-based deliveries. Despite this, intervention, health facility deliveries in Machakos County are still low. This study aimed to identify hindrances and enablers of the FMS program in Machakos County. METHODS: it was a cross-sectional study conducted among postnatal women who delivered between September 2018 and September 2019 in Machakos County. A total of 394 women were enrolled. Data was collected using questionnaires and focus group discussions. Key informant interviews were conducted using nursing officer in charge of selected health facilities. Qualitative data was analyzed using chi-square and fishers exact. Multivariate logistic regression was used to determine predictors of utilization of FMS. Statistical significance was set at p < 0.05. RESULTS: utilization of FMS in Machakos County was 75.6%. Factors that were associated with utilization of FMS included marital status (p = 0.006), parity (p = 0.038), distance from health facility (p = 0.000), services offered during labour (p = 0.000), treatment of mothers by healthcare workers during labour (p = 0.000), provision of adequate food (p = 0.005), quality of service (p = 0.000) and cleanliness of the maternity ward (p = 0.000). CONCLUSION: utilization of FMS in Machakos County is optimal. Health facilities should be supported to offer FMS by providing them with necessary supplies.
