By Doris Kathia
The Linda Mama program, in theory, is a commendable initiative. It aligns with international health targets, such as reducing the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. As observed in various settings, the real impact of a policy depends not only on its design but also on how it is executed. The experience with Linda Mama highlights the need for a critical assessment of the implementation process, particularly in complex healthcare systems. The challenges highlighted by the auditor general must be addressed to ensure that the program delivers on its promise.
Expectant mothers in Kenya continue to face financial burdens when seeking maternity services, including the purchase of essential drugs, despite the government’s promise of free maternity services through the Linda Mama programme. The Linda Mama programme under the umbrella of the National Hospital Insurance Fund (NHIF), was rolled out with the promise of providing universal access to free maternity services to expectant mothers, ensuring they receive the essential care they need during pregnancy and childbirth. This government initiative was launched in June 2013 by President Uhuru Kenyatta, aiming to alleviate the financial burden on pregnant women.
The Linda Mama programme aimed to provide services based on need rather than the ability to pay, a step towards achieving Universal Health Coverage (UHC) in Kenya. The program includes a comprehensive package of antenatal and postnatal care, preventive services, and the prevention of mother-to-child transmission of HIV. However, a recent audit report by Auditor General Nancy Gathungu reveals that despite the program’s existence, poor expectant mothers are still compelled to incur out-of-pocket financial expenses, including purchasing drugs. The audit report reveals the gap between policy formulation and implementation. It also raises concerns about health equity, a key principle that the Linda Mama program is supposed to uphold.
It’s crucial to note that the Linda Mama program was not intended merely to be a free service, but a quality one. The implementation gaps not only impose unexpected financial burdens on families but also could potentially compromise the quality of healthcare received by mothers and their newborns. The existence of hidden costs, even after the government declared maternity services to be free, discourages women from seeking necessary care, thus defeating the program’s primary purpose.
The Linda Mama program was meant to be a pro-poor policy, aiming to benefit those who need it the most. Since the government moved the management of the free maternity program from the Ministry of Health to the NHIF in 2016 and expanded service access to include private providers, the operational efficiency of the program seems to have suffered. The audit report suggests that the problem might lie in the program’s funding and management.
It requires robust monitoring and accountability mechanisms to ensure funds are correctly used and services are delivered as promised. Additionally, there is a need for continuous training and capacity building of health workers to ensure quality care. The government must also consider strengthening public health facilities and ensuring a regular supply of drugs to avoid out-of-pocket expenses by beneficiaries.
In conclusion, the Linda Mama program possesses the potential to revolutionize maternal and child health services in Kenya, but its success is dependent upon effective implementation. The government needs to address these challenges head-on to ensure that the ideal of universal access to maternal and child health services becomes a reality for all Kenyan mothers. To achieve its goal of reducing maternal mortality and ensuring universal access to maternity care, Kenya must address the weaknesses in the Linda Mama program. This involves not only eliminating hidden costs but also enhancing the quality and reach of maternal healthcare services.
Ms. Kathia, a communications specialist, is a Sexual and Reproductive Health and rights and Youth Advocate at NAYA Kenya. doriskathia@gmail.com
