Abstract:
Background Reducing maternal, newborn and child mortality remains one of the top global public health priorities.
Each year, approximately 303,000 mothers, globally, die during delivery. Stillbirths and neonatal deaths within
the first 28 days of life are estimated at 2.6 million and 2.7 million, respectively. Rural residents face challenges in
accessing health care due to difficulties in transportation. Given the voucher-based transport’s potential to address
inaccessibility to health services, this study explored the health stakeholders’ perspectives on the benefits and
challenges of this intervention.
Methods Using an exploratory qualitative design, this study was conducted in Kitui County located in the lower
Eastern part of Kenya. The study was conducted from July to August 2023, with data collection occurring over a twoweek period in August 2023. Participants were purposively drawn from the six wards in Kitui South Sub County. The
interview guide included questions on views, experiences, challenges, and perspectives on voucher-based transport
system for skilled birth attendance. Data triangulation was ensured through audio-recorded Focus Group Discussions
(FGDs) and Key Informant Interviews (KIIs). All audio recordings were transcribed verbatim, coded and thematically
analyzed, using a holistic approach.
Results Perceived benefits of Skilled Birth Attendance (SBA) champions model included improved access to
delivery services, improved health outcomes and socioeconomic and awareness benefits. The perceived challenges
and concerns of the SBA model included economic and sustainability challenges, infrastructure and connectivity
challenges, as well as administrative and logistical challenges.
Conclusions Overall, the SBA Champions model has proven effective in improving access to maternal services within
the community, but prevailing challenges and sustainability issues need to be addressed. Additionally, the study
provided strategic information to inform policy makers about the model and strengthen MCH policy.
