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http://ir.mu.ac.ke:8080/jspui/handle/123456789/6906
Title: | Strengthening weak healthcare systems for maternal and neonatal care in low and middle income countries: The missing link |
Authors: | Nyongesa, Paul Yego, Faith Tonui, Philiph Itsura, Peter Sorre, Bennad Omar, Egessah O. |
Keywords: | WHO building blocks Low and middle-income countries Maternal and newborn health Strengthening health systems Community engagement pillar |
Issue Date: | 23-Dec-2021 |
Publisher: | Scientific Research Publishing Inc. |
Abstract: | Introduction: Preventable maternal and newborn mortalities still occur in local communities in Kenya since access to maternal and newborn healthcare services remains a big challenge. Barriers to access in resource-constrained settings have not been examined adequately in literature. The World Health Organization (WHO) has 6 building blocks for strengthening healthcare sys- tems that informed this study. This paper examines how user-side and insti- tutional factors influence access and use of Maternal and Newborn Health- care (MNH) Services in Matayos sub-County-Busia County. Methods: A mixed method approach, with an ethnographic inquiry and a descriptive cross-sectional design, was adopted to assess access to MNH services in Ma- tayos-Busia County, Western Kenya. Postpartum women who had delivered within the previous 12 months and health care providers in the study area were recruited as respondents. A total of 348 postpartum women were se- lected through stratified systematic random sampling for the survey. Purpo- sive sampling was used to select postpartum women, conventional and tradi- tional health care providers for 16 in-depth interviews and 7 focus group dis- cussions. Data were analyzed using descriptive and inferential statistics. Qua- litative data analysis was done thematically. Results: Institutional delivery was low at 68% and family planning at 75% although demand for services was high at 99%. User-side barriers to access included shared beliefs and practices in the community; high direct transport costs from home; and high costs for missing drugs and other supplies in hospitals. Middle (5th -7 th ) order deliveries occurred at home with traditional birth attendants. The choice of place of de- livery in households was influenced by spouses to respondents and commun- ities of residence where respondents lived or were married. All 6 WHO health ystem building blocks were weak in Matayos sub-County and needed sys- tem-wide strengthening involving all pillars. The user-community voice alone was insufficient and the 7th pillar for user-community engagement was ab- sent. The underlying factors were weak governance and under funding for healthcare. Conclusion: The six WHO building blocks were inadequate due to weak governance and inadequate funding. User-community engagement, the 7th Pillar, was absent in these resource-limited settings. We recommend user-community empowerment, engagement and participation, adoption of a system thinking approach and adequate funding. |
URI: | http://ir.mu.ac.ke:8080/jspui/handle/123456789/6906 |
ISSN: | 2164-5205 |
Appears in Collections: | School of Medicine |
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