Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya, 2007-2013.


Kihara, AB; Harries, AD; Bissell, K; Kizito, W; Van Den Berg, R; Mueke, S; Mwangi, A; Sitene, JC; Gathara, D; Kosgei, RJ; Kiarie, J; Gichangi, P; (2014) Antenatal care and pregnancy outcomes in a safe motherhood health voucher system in rural Kenya, 2007-2013. Public Health Action, 5 (1). pp. 23-9. ISSN 2220-8372 DOI: https://doi.org/10.5588/pha.14.0070

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Abstract

A rural private health facility, Ruby Medical Centre (RMC), participating in a safe motherhood health voucher system for poor women in Kiambu County, Kenya. Between 2007 and 2013, to determine 1) the number of women who delivered at the RMC, their characteristics and pregnancy-related outcomes, and 2) the number of women who received an incomplete antenatal care (ANC) package and associated factors. Retrospective cross-sectional study using routine programme data. During the study period, 2635 women delivered at the RMC: 50% were aged 16-24 years, 60% transferred in from other facilities and 59% started ANC in the third trimester of pregnancy. Of the 2635 women, 1793 (68%) received an incomplete ANC package: 347 (13%) missed essential blood tests, 312 (12%) missed the tetanus toxoid immunisation and 1672 (65%) had fewer than four visits. Presenting late and starting ANC elsewhere were associated with an incomplete package. One pregnancy-related mortality occurred; the stillbirth rate was 10 per 1000 births. This first assessment of the health voucher system in rural Kenya showed problems in ANC quality. Despite favourable pregnancy-related outcomes, increased efforts should be made to ensure earlier presentation of pregnant women, comprehensive ANC, and more consistent and accurate monitoring of reproductive indicators and interventions. Abstract available from the publisher. Abstract available from the publisher.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
PubMed ID: 26400598
URI: http://researchonline.lshtm.ac.uk/id/eprint/2312443

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