A report by The Open Society Initiative for Eastern Africa (OSIEA) has revealed that inadequate funding of the government’s free maternity program has failed to meet the need of expectant mothers seeking facility-based delivery in Kenya, as new mothers are being discharged prematurely and that there are key gaps in the implementation of the free maternal health care declaration.
Insufficient information at the community level to influence demand for quality services, low public participation in the policy development and structures that guide maternal health care and impact of culture in maternal health making pregnancy a private affair remains a challenge to maternal mortality.
The National Hospital Insurance Fund (NHIF), reimburses only Ksh5,000 for every delivery, whether normal or by cesarean sections in levels four and five public health facilities, while the reimbursement for private facility delivery under Linda Mama is set at Ksh 17,000 for cesarean and Ksh6,000 for normal delivery, an amount which the report recommends should be raised to Ksh16,000 for normal delivery and Ksh30,000 for cesarean.
This is a clear indicator that the funding formula channels more money into the private health sector, while expectant mothers in the are not well catered for as they have to purchase cotton wool and surgical blades which are among the necessities expectant mothers have to pay for in some public hospitals. According to the Investigator, most of the reimbursements were not forthcoming, forcing the facilities to provide poor quality services as well as being forced to refer clients to private health facilities where they were expected to pay for the services because of lack of basic supplies.
OSIEA’s Co-Investigator, Dr. Rhoune Ochako said that the government should involve more stakeholders in the policy formulation and implementation to enhance uptake of maternal health care services, adding that community-level accountability mechanisms should also be enhanced and all maternal deaths reported and documented and where possible corrective measures are taken to avoid repeat occurrences.