|dc.description.abstract||Background: Reduction of pregnancy related mortalities remains one of the
greatest health challenges globally. For a long time, low utilization of maternal
health care services has been attributed to the unaffordability of services. The
government of Kenya waived delivery charges in public health facilities
through a free maternal health care policy in June 2013 with an aim of
encouraging facility based deliveries and subsequently reducing maternal
Objectives: To describe the causes of maternal mortality 2 years before the
implementation of the free maternal health care policy in Kenya (June 2011-
May 2013) and 2 years after the policy intervention (June 2013-May 2015).
Design: This study was of a quasi-experimental design.
Setting: The study was carried out in 77 public health facilities in Kenya.
Subjects: The study subjects for this study were 872 deceased mothers.
Results: The largest proportion of deaths was as a result of direct causes, 79.1%
before the policy 74.9% after the policy intervention. Haemorrhage,
hypertensive disorders, complications of abortion and sepsis/infections were
the most common direct causes of maternal mortality pre and post policy
intervention. There were no significant changes in the causes of maternal
following the free maternal health care policy implementation (P>0.05). The
free maternal health care policy has not improved the chances of survival for
mothers delivering in the 77 public health facilities (odds ratio=0.9722).
Conclusion: The implementation of the free maternal health care policy has not
influenced the causes of maternal mortality in Kenyan public health facilities.||en_US