EFFECTS OF “OPARANYA CARE SERVICES” IN IMPROVING SKILLED DELIVERY IN MALAVA COUNTY HOSPITAL KAKAMEGA COUNTY KENYA
Kipruto Bungei, Richard
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is estimated that nearly 300,000 women die from pregnancy related complications and childbirth. Globally 34% of deliveries take place without skilled birth attendant. In Kenya more than 50% of deliveries are conducted by unskilled persons. These high indices of maternal mortality led to the launching of incentive use and digital programme in Kakamega County commonly known as “Oparanya care services”. Despite the commitment provided by the county government in resource allocation and free maternity care from the national government, pregnant women still deliver under watch of unskilled attendants, which endangers the outcome of the delivery. The main objective of the study was to assess the effects of “Oparanya Care Services” in improving skilled delivery of mothers in Malava County Hospital. The specific objectives of the study were to determine the awareness of digital care programme, compare utilization of Focused Antenatal Care in beneficiaries and non-beneficiaries of Oparanya Care and investigate the effects of Incentive use on the skilled delivery. The study is based on Andersen’s (2005) behavioral models of health services, where three set of individual characteristics which influence an individual choice of skilled delivery to include demographic, social and enabling factors. The study was conducted in Malava County hospital, Kakamega County and the target population comprised all mothers within reproductive age bracket 18-49 years and attending ANC facility at the hospital. The study employed cross-sectional descriptive study design. Purposive sampling was used to identify the hospital while systematic sampling was adopted in selecting the 402 respondents who comprised of beneficiaries and non-beneficiaries in Oparanya care services. Data was collected using a structured questionnaire and was analyzed using SPSS version 20.0. Descriptive statistics, frequencies, percentages and means were used to summarize the research findings while odds ratio (OR) and logistic regression were used to establish relationships between independent and dependent variables at α=0.05. The study results indicated that the mean age (in years) was 29.1 and 30.4 years for beneficiaries and non-beneficiaries respectively. In addition, all (100%) of the beneficiaries and non-beneficiaries were aware of the digital programme running in the County hospital. Those who benefited from the programme attended ANC promptly compared to the non- beneficiaries. Being a beneficiary influenced mothers to seek skilled delivery promptly at the facility among other factors (pvalue< 0.05). The utilization of focused antenatal care was influenced by factors such as history of chronic illness, high blood pressure, complications during pregnancy and history of losing a child. The findings of this study suggest that incentive use in “Oparanya Care Services” significantly improves skilled delivery of mothers in Malava County Hospital. The study recommends creating more awareness on OC programme, formulation of a robust assessment of beneficiaries and boosting hospital workforce, particularly the ANC staff.