Strategic factors influencing maternal healthcare services amongst mothers in Masaba district hospital in Nyamira county Kenya

  • Stella M Omari Kisii Univaersity
  • Solomon Kokwo Pkiach


Postnatal services are available in most of the hospitals in Kenya and mothers expected to go for postnatal services at any hospital of their choice after delivery vary by age, socio-economic backgrounds and educational levels. However, a small number of women turn up for postnatal services. The purpose of the study was to assess the strategic factors influencing maternal healthcare services amongst mothers attending postnatal clinic in Masaba District Hospital, Kenya. The specific objectives were: to assess the factors influencing the utilization of postnatal services among mothers in Masaba district hospital; to explore mothers’ awareness about postnatal services in Masaba district hospital and to determine the challenges facing health care providers in providing postnatal care to mothers in Masaba district hospital. This was a descriptive cross-sectional survey in which 142 post-natal mothers participated. Data was collected by use of questionnaire for the mothers and through Key Informant Interviews for the health care providers and hospital managers. The data was analyzed using frequencies, means and Chi-Square. The findings indicated that care provided to the clients during delivery had significant effect on attending post-natal services as compared to knowledge of post-natal services, equally, distance to the health facilities, occupation and ability to pay the cost of the post-natal services influenced attendance. Poor staff attitude, lack of awareness, lack of adequate supplies and infrastructure were challenges that affect provision and hence utilization of post-natal services in the hospital. Strategic efforts and planning needs to be directed towards provision of adequate, client friendly services in an environment that is both conducive to the health worker and to the client seeking the services.

Author Biography

Stella M Omari, Kisii Univaersity

Senior lecturer, Department of Human Resource

School of Business and Economics,



Anderson, R. M. (1995). Revisiting the Behavioural Model and Access to Medical Care: Does it Matter? Journal of Health and Social Behavior, 36(1): 1-10.
Ashford, L. (2004). Hidden Suffering: Disabilities from Pregnancy and Childbirth in Less Developed Countries. Population Reference Bureau, 1-6.
Bless, C. &Higson-Smith, C. (2000). Fundamentals of Social Research Methods: An African Perspective. Juta Education, (pty) Ltd.
Bryson, J.M. (2004). Strategic planning for public and nonprofit organizations: a guide to strengthening and sustaining organizational achievement (3rd ed.). SanFrancisco: Jossey-Bass.
Bryson, J.M. & Roering, W.D. (1988). Initiation of strategic planning by governments. Public Administration Review, 48 (6), 995-1004.
Chou, K. L., Mak, K. Y. & Chan, K. F. (2002).The Utilization of Health Care and Social Services by Neurotic Patients. Health Services Research report #7120007: Hong Kong council of social services.
Delvaux, T., Buekens, P., Godin, I. &Bouston, M. (2001). Barriers to Prenatal Care in Europe. American Journal of Preventive Medicine, 21(1): 52-59.
Dennill, K., King, L. &Swanepoel, T. (1999).Aspects of Primary Health Care: Community Health Care in South Africa (2nd edn.). Oxford, Southern Africa, Cape Town.
Dunlop, S., Coyte, P. C. &McIsaac, W. (2000). Socio-economic Status and the Utilization of
Physicians’ Services: Results from the Canadian National Health Population Health Survey. Social Science and Medicine, 51(1): 123-33.
Griffiths, P. & Stephenson, R. (2001). Understanding Users Perspectives of Barriers to Maternal Health care use in Maharashtra, India. Journal of Biosocial Science, 33(3): 339-59.
Hove, I., Siziya, S., Katilo, C. &Tshimanga, M. (1999). Prevalence and associated factors for non-utilization of postnatal care services: Population-based study in KuwadzanaPeri-urban area, Zvimba district of Mashonaland West Province, Zimbabwe. African Journal of Reproductive Health, 3(2): 25-32.
Hulsey, M. T., Laken, M., Miller, V. & Ager, J. (2000).The influence of attitudes about unintended pregnancy on use of prenatal care and postpartum care. Journal of Perinatology, 20(8): 513-519.
Kalmuss, D. &Fennelly, K. (1990). Barriers to prenatal care among low-income women in New York City. Family Planning Perspective, 22(5): 215-8, & 231.
Kaufmann, K. (2002). An analysis of transport in the Zululand health district.Conference report. Retrieved from
Ladfors, L., Erickson, M., Mattson, L., Kyleback, K., Magnusson, l. & Milsom, I.(2001). A population based study of Swedish women’s opinions about antenatal, delivery and postpartum care. Acta Obstetricia Gynecologica Scandinavica, 80(2):130-136.
Livingstone, L. (1990). Development of individual physiotherapy treatment programs: Specific post-natal problems, follow-up care, physiotherapy plus caesarean section. In R., Sapsford, J., Bullock-Saxton & S., Markwell (eds), Women’s health a textbook for physiotherapists. London, Harcourt Brace: 220-246.
Lorange, P., & Vancil, R.F. (2000). How to design a strategic planning system. Harvard Business Review, 54 (5), 75-81.
Marshall, D. R. (2004). Strategic planning: one size doesn’t fit all. University Business, 7, 11-12.
Mwaniki, P. K., Kabiru, E.W. &Mbugua, G. G. (2002). Utilization of antenatal and maternity
services by mothers seeking child welfare services in Mbeere District, Eastern Province, Kenya. East African Medical Journal, 79(4): 184-7.
Mugenda, O. & Mugenda, (2007).Quantitative and Qualitative Research Methods. Kenyatta University Press, Nairobi.
Navaneetham, K. &Dharmalingam, A. (2002).Utilization of maternal health care services in southern India. Social Science and Medicine, 55(10): 1849-69.
Nunnally, J. C. (1978). Psychometric theory. New York, McGraw-Hill.
Ottawa Charter for health promotion (1986). WHO, Geneva: the Adelaide recommendations on healthy public policy. Conference report.
Pataya, K., Wendy, M. & Debra, C. (2003). Traditional practices among Thai women. Journal of Advanced Nursing, 41(4): 358-367.
Policy project (1999). Maternal and neonatal program index (MNPI): A tool for maternal health advocates. Published project report: Maternal health and child study.
Rower, R. & Garcia, J. (2003).Access to care for low-income child bearing women. Evidence on access to maternity and infant care in England. Unpublished project report. Oxford University Institute of health sciences: Maternal Perinatal Epidemiology Unit.
Safe Motherhood (2002).Safe Motherhood: a matter of human rights and social justice. Retrieved from
Sibanda, J. Q., Saungweme, I., Nleya, C., Mutyambizi, M. P. & Rutgers, R. A. (2001). Postnatal care in Bubi district deserves more attention. Central AfricanJournal of Medicine, 47(4): 103-8.
Starfield, S. (1992).Primary Care: concepts, evaluation, and policy. New York, Oxford University press.
Stephenson, R. &Tsui, O. A. (2002). Contextual influences on reproductive health service use in Uttar Pradesh, India. Studies in Family Planning, 33(4): 309 –321.
Soltani, M. S., Sakouhi, M., Belguith, Z., Salem, B. K., Gacem, H. &Bchir, A. (1999).Evaluation of mothers’ knowledge in pre- and postnatal preventive care in the Tunisian Sahel.Sante Pluque, 11(2): 203-210.
United Nations (2002).World Programme of Action Concerning Disabled Persons. Retrieved from on 25/4/2003.
Wakeel A. Isola & Alani R. A.(2011). Human capital development and economic growth: Empirical evidence from Nigeria. Asian economic and Financial Review. 2(7):813-827
Webster, J., Prichard, M. A., Linnane, J. W.J., Roberts, J. A. & Hinson, J. K. (2001).Postnatal depression with health care providers. Journal of Quality in Clinical Practice, 21: 144-148.
WHO (2004).Making pregnancy safer: why is this issue important? Retrieved from www.who.milleniumgoalsformaternalhealth.htm on 28/03/2004.
WHO (2001).IDS health information bulletin: WHO country office for Uganda. WHO report.
WHO (1991). A call for action: Promoting health in developing countries. Health Education Quarterly, 18(1): 5-15.
York, R., Tulman, L. & Brown, K. (2000). Postnatal Care in Low-Income Urban African American Women: Relationship to Level of Prenatal Care Sought. Journal of Perinatology, 20(1): 34-7.