As a result, most of them end up being detained in private hospitals due to their inability to clear their bills.
A recent report shows the trend is an indicator that even poor women doubt the quality of services provided in the public health system.
The study was conducted by Open Society Initiative for Eastern Africa with an aim to review the impact of free maternity services on maternal mortality in Nairobi, Kilifi and Migori counties.
The report, ‘The Impact of Government Supported Maternal Health Programs on Maternal Health Outcomes in Kenya; hits, misses and lessons’, was released in December.
According to the report, the free maternity services introduced by the government in 2013 are also shunned by women who ‘don’t value free things’.
The report shows that middle-class women view free maternity services as meant for the poor.
“The presumption that all people value free things also came into sharp focus. People rarely value free things and Kenyans ordinarily get very suspicious of what is provided to them for free,” the report states.
“They always think that there are strings attached which may also hamper the proper utilisation of services,” it adds.
Some women interviewed said their communities do not go for free things. Others said a “valued pregnancy” cannot be free.
The survey also found that women in some communities are still being held back by cultural beliefs and values in relation to pregnancy and childbirth.
In some communities, giving birth alone in the house, garden or on the way to the market is seen as being courageous and brave, the dangers notwithstanding.
“Pregnancy and childbirth is an aspect that must be experienced within the cultural context. All pregnancies can be death sentences and when you die, you cannot blame anyone. The traditional birth attendants are very good and try to assist, so we cannot report them to authorities since it is never their wish to see any of their client die,” a woman from Rongo told the officials.
The report shows that the number of women seeking antenatal care services increased from 2013 after the declaration of free maternity services, but the human resource has remained the same.
Two referral hospitals reported that maternal mortality had increased because there was a tendency to focus more on complicated referral cases.
Many times, postgraduate doctors who are not compensated do the work in assistance with part-time nurses to mitigate the overwhelming work.
“On this basis, there is a need to rethink the entire process if we are to make the maternal health care services work for the entire population.”