HP+ costing work helping to expand Kenya's free maternal health program, reaching 700,000 women each year
October 29, 2016
On October 18, 2016, the government of Kenya re-launched their free maternity services program, re-envisioned and under a new name. Linda Mama, as the program is now known, will be administered by Kenya's National Health Insurance Fund (NHIF) and will offer free maternity services at all public health facilities and at an additional 2,000 private-sector and 700 faith-based facilities. The program also now provides expanded services, covering outpatient and inpatient services for both mothers and babies, including antenatal, delivery and neonatal, and postnatal care and one year of pediatric services. Linda Mama is estimated to reach 700,000 women each year.
Photo courtesy of NHIF
Speaking at the launch, on behalf of President Uhuru Kenyatta, the Cabinet Secretary for Health, Dr. Cleopas Mailu, announced that the government had set aside Kshs 5.4 billion this fiscal year (FY) to cover reimbursements to facilities offering the service. "Beneficiaries under the first phase of the roll-out will access services in 5,073 facilities across Kenya," Dr. Mailu said. Under the new program, NHIF will reimburse facilities directly, whereas under the previous program facilities were reimbursed by the national government, through the counties.
The launch of Linda Mama comes after several months of intensive work to redesign free maternity services, in a bid to expand coverage and enhance administrative efficiency. The decision to move the program to the NHIF was made in order to secure its long-term sustainability and ease logistical difficulties with reimbursements. The USAID-funded Health Policy Plus (HP+) project provided assistance to Kenya's Ministry of Health (MoH) and the NHIF to re-design the program and to cost the benefits package, ensuring that the government allocated adequate resources. HP+ supported the MoH to collect and synthesize data on what resources were required to implement the program under NHIF. Results from that analysis informed the program's reimbursement rates for faith-based and private sector facilities. "Our cost estimation was a crucial element in the process and is what was used to inform the rollout budget of about Kshs 6 billion," said Thomas Maina, HP+ senior health economist in Kenya.
HP+ also assisted the Ministry to prepare policy documents related to the redesign, which included a Cabinet Memorandum requesting cabinet approval for increased allocation to the free maternity services program, implementation guidelines, and a technical policy proposal. HP+ staff also provided assistance to the NHIF to develop a communication strategy to guide the introduction of the redesigned program, and also contributed to the development of the communications materials required to support the program.
The free maternity care program was first introduced in 2013 after shocking statistics revealed that over 6,000 women were dying every year from preventable causes during pregnancy and childbirth. Since then, the government has cumulatively invested over Kshs 9 billion in the program, enabling over 500,000 women to access maternity services and leading to an increase in facility deliveries from 44 percent before the policy was in place to 66 percent in FY 2012/13. Reports suggest that many poor mothers, who would otherwise have delivered at home, now choose to deliver their babies at health facilities. To benefit from Linda Mama, pregnant women will have to enroll directly at a facility or through a mobile phone platform.
"Linda Mama is a game-changer initiative that will transform maternal healthcare in the country," said Mohammed Ali, NHIF's board chairman at the launch, adding that the NHIF will run the program in an efficient and professional manner.
Source: Government of Kenya, Ministry of Health. 2016. Health Sector Working Group Report 2017-18 to 2019-20. Nairobi: Ministry of Health.
