Accessibility and Health Facility Factors Influencing Maternal and Fetal Outcomes among Mothers Referred with Obstetric Emergencies in Baringo County Referral Hospital, Kabarnet, Kenya

Purpose: To determine the accessibility to a health facility and health facility factors influencing maternal and fetal outcomes among mothers referred with obstetric emergencies in Baringo County referral Hospital. 
Methodology: A descriptive cross-sectional study which employed a mixed method approach of data collection was adopted. Simple Random technique was used in selecting 284 respondents into the study. The study population also included nurses, gynaecologist and medical officers who were purposively sampled. Qualitative data collection was analysed through content analysis while descriptive and inferential statistics were used to analysed quantitative data.  
Findings: results show that mothers who are accompanied by nurse are 4.3 times more likely to have complications than those accompanied by relatives (AOR:4.3;95% CI:1.2-16.1;p=0.03). Moreover, mothers who were coming from distant health facilities were 70% less likely to have experience complications than those who live closer to the referral hospital (AOR: 0.3; 95%CI: 0.1-1.1; p=0.07). Neonates whose mothers received treatment within 30 min (OR: 0.5; 95% CI: 0.3 – 0.8; p = 0.005) were 50% less likely to have had abnormal outcome. In contrast, the risk of abnormal outcome was higher for neonates whose mothers received treatment before referral (OR: 2.3; 95% CI: 1.4 – 3.8; p = 0. 001) suggesting possible delay in providing treatment as a possible cause of deteriorating condition of the foetus. Mothers who stated that nurses listened and explained things (3.9%) or those seen within less than 30 minutes to be attended to (p = 0.3) experienced complications. On the other hand, the odds of complications increased where the main reason for referral was lack of expertise and equipments at the referring health facility (p = 0.09) though the result was not statistically significant. 
Unique Contribution to Theory, Practice and Policy: This study has identified accessibility and health facility factors influencing the obstetric emergencies in a marginalized county. The study will provide insight to policy maker’s hence evident-based interventions will be made. No literature review has been published on this topic at the study site therefore, this study will form a basis for other researchers.