How free maternity program changed lives in Kenya
By Lilian Kaivilu
Three years after President Uhuru Kenyatta announced free maternity to all Kenyan mothers, the government launched the Linda Mama program. The free maternity initiative that was officially launched in April 2017 would be administered through the National Hospital Insurance Fund (NHIF). Lilian Kaivilu spoke to mothers who have benefitted from the program and their experience one year later.
Emelda Awuor Olonde sits quietly at the waiting bench at Ogongo sub county hospital in Homabay County. She is busy reading something on her Linda Mama maternity card. This is a card that pregnant and nursing mothers in Kenya use to access free maternity in NHIF accredited health facilities across the country. “I am just confirming that I have attended all the ante natal visits as required,” she tells me as I join her in the hospital waiting area.
Olonde is now expecting her first born child and is due later this month. The calm depicted by the 24-year-old first time mother catches my attention. Ordinarily, a first time mother would be anxious ahead of delivery. “There is nothing new here. I am well prepared,” she says with a lot of confidence.
After her first visit at this health centre in October 2017, Olonde learnt that she was pregnant. And with no income to sustain the required antenatal visits, she hoped that hers would be a normal pregnancy with no complications. “I was not ready to the back and forth visits to the health facility since knew I could not afford the Sh70 busfare from my Ogando village, let alone the hospital charges,” she says.
Unaware of the way forward, a worried Olonde held a brief chat with the nurse on duty that day, expressing her concerns about the financial cost of her pregnancy. The nurse in charge of the hospital introduced her to Linda Mama program, a public funded health initiative launched in October 2016 by the Kenyan government that seeks to provide affordable healthcare to pregnant women and infants in the country through the National Hospital Insurance Fund (NHIF).
Olonde first heard of the free maternity services when she tested positive for pregnancy. “A nurse at the hospital explained to me the benefits of the program and immediately enrolled me. Now I know I will give birth for free and have my baby’s health on track.” She, however, will enjoy the benefits of the program upto only four post natal care visits.
Previously, Olonde would pay Sh420 at the health facility. “I did not know that I was pregnant so when I came to the hospital, I would pay from my pocket. At times I would pay upto Sh1,000 if there were laboratory tests involved.”
The 24-year-old is optimistic that she will have a smooth delivery. She has so far sought alternative means of transport should labour pains come early. “I have already contacted a motorbike rider to stay alert to take me to the hospital when am ready for delivery,” she says.
With the Linda Mama card, expectant mothers at the Ogongo Sub County Hospital access free pregnancy-related laboratory tests, consultation and drugs from the hospital pharmacy. “Linda mama has really helped me as a first time mother. I am now more confident to bear children,” she says.
Everlyne Akinyi joins the queue just as we are about to conclude our conversation. She is eight months pregnant. Achieng is just on time for her third and last clinic. This is her second pregnancy after delivering twins three years ago.
Akinyi registered into the Linda Mama program in December 2017 at Ogongo Sub County Hospital. She was then four-months pregnant. “With this card, I am able to properly plan my ante natal visits. Linda Mama has really helped me because I no longer pay anything to attend the clinic. I am also assured of regular medical check-up.”
According to her, the programme has helped economically disadvantaged women. The mother of two, however, is worried about her other two children. “My twins are not in this Linda Mama programme. I registered in the program later after I had given birth hence I could not qualify for free medical attention should there arise any complication,” she says.
According to Lilian Okoth, the nursing officer in charge of Ogongo sub county hospital, the program is challenging to health facilities that do not have reliable electricity and internet. With requirements to record birth notifications within 24 hours, Okoth says this is not realistic to health facilities with limited or no electricity at all. “Last month, using a personal modem, I managed to capture details of only five mothers out of the 40 who delivered at our health facility. That means we lost the reimbursement for the other 35 mothers in that month alone. Okoth says the hospital did not have reliable internet hence the delayed recording of the data.
But Malims Ouma, NHIF branch manager in Homabay County says that health facilities in the region can always reach out to the branch office for assistance in filing claims.
Missing information, Ouma says, can delay the process of NHIF claims payments. In order for NHIF to initiate payment to health facility the latter need to submit a copy of the mother’s identity card or that of the guardian, the antenatal card of the mother and the relevant claim numbers. The claims are paid within 21 days after the submission of required documents.