title: Implementation challenges of free maternity services policy in Kenya: the health workers' perspective.
abstract: BACKGROUND
  Kenya implemented the policy of free maternity services to reduce maternal mortality and morbidity. For successful implementation of this policy, there is need to monitor the implementation progress, identify the challenges and mitigate them and determine better strategies for implementation based on emerging implementation issues. This study was carried out to determine the challenges facing policy implementation and strategies for better implementation.
  
  
  METHODS
  This was a cross-sectional descriptive study carried at the Rift Valley Provincial General Hospital (RVPGH) and Bondeni maternity. All the staff who work at Bondeni Maternity (including nursing officer in-charge) were included in the study. All the staff who work at the Maternity Unit of the RVPGH were included in the study, as well as the Medical Superintendent of the facility. A total of 110 respondents were sampled. A questionnaire and interview guide were used to collect data. Data was analyzed using SPSS software.
  
  
  RESULTS
  A response rate of 91% (n=100) was achieved. Major implementation challenges include inadequate supplies (86%), inadequate funding (38%), staff shortage (92%), lack of motivation among health workers (62%), overwhelming workload (89%) and abuse of services by clients (32%). Strategies for better implementation include employment of more staff, motivation of health workers, improvement in policy financing, training of health workers and provision of adequate supplies.
  
  
  CONCLUSIONS
  Implementation of free maternity services policy in Kenya is facing challenges but there exists strategies, which, if implemented, will help address these challenges.
authors.affiliation: Department of Health Systems Management, Kenya Methodist University.
authors.forename: Emmanuel Wekesa
authors.initials: EW
authors.lastname: Wamalwa
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000458:organization & administration / Q000706:statistics & numerical data*; D006291:Health Policy; D061889:Healthcare Financing; D006801:Humans; D007630:Kenya; D008297:Male; D008427:Maternal Health Services / Q000191:economics / Q000458:organization & administration*; D008428:Maternal Mortality; D009042:Motivation; D011795:Surveys and Questionnaires; D016526:Workload
keywords: Free maternity services policy; implementation challenges; recommendations