Analytical Review of the Association between Maternal Health Outcomes and Cost of Ambulance Referral Network in Wajir County, Kenya

Abstract

Worldwide, every year more than half million women die in childbirth. About 99% of these maternal mortalities occur in Sub-Saharan. Majority of these deaths are attributed to delay in accessing maternal health care. In Kenya, ambulance referral services have been provided to reduce the delay in accessing maternal health care. However, their performance remains largely unevaluated. Therefore, this study was undertaken to perform analytical review of the association between maternal health outcomes and cost of ambulance referral network interventions in Wajir County, Kenya. This was a longitudinal retro-prospective time series study, specifically to determine the cost and effectiveness of ambulance referral networks on maternal health outcomes. Data was collected from ambulance logbooks, patient registers, logistics records, and maternal death surveillance records. A population of 623 records had used ambulance during referral within the county was achieved during sourcing data for this study from records. Thus, secondary data contains both quantitative and qualitative data. Data was analysed using both descriptive and inferential statistics. Percentages, frequency, and mean. Inferential statistics used was chi-square. To determine effects of total ambulance cost on maternal health outcomes, multinomial regression analysis was employed. Results were presented in tables and figures. The results indicate that total ambulance cost, had significant effect at 5% level of significant. Cost of fuel per referral, and cost of equipment's were found to affect all maternal health outcomes significantly at p<0.05. Therefore, to reduce infant and maternal mortality rate in Wajir County, the county should provide enough budget for   ambulance referral networks.