Health policy related to an identified health risk or disparity.

Health Policy Addressing Maternal Mortality Disparity in Kenya

Identified Health Risk/Disparity: A significant disparity exists in maternal mortality rates in Kenya, with women in rural areas and those from lower socioeconomic backgrounds experiencing disproportionately higher rates of death during pregnancy, childbirth, and the postpartum period compared to their urban and wealthier counterparts. This disparity is linked to factors such as limited access to skilled birth attendants, inadequate emergency obstetric care, poor infrastructure, cultural practices, and lower levels of health literacy.  

Health Policy: The “Linda Mama, Boresha Afya” (Safe Motherhood, Improved Health) Initiative is a national health policy in Kenya aimed at reducing maternal and newborn mortality and morbidity, with a specific focus on addressing geographical and socioeconomic disparities in access to quality maternal healthcare services. Launched in 2013 and integrated into the National Hospital Insurance Fund (NHIF), the policy provides free maternity care services to all pregnant women in Kenya, regardless of their socioeconomic status or geographical location. These services include antenatal care, delivery (both normal and cesarean section), postnatal care, and treatment of pregnancy-related complications in accredited public, private, and faith-based health facilities.

Intended Impact: The intended impact of the “Linda Mama” policy is to:

• Increase access to skilled birth attendance: By removing financial barriers, the policy aims to encourage more pregnant women, especially those in underserved areas, to deliver under the care of qualified healthcare professionals.  
• Improve utilization of antenatal and postnatal care services: Free access is expected to lead to earlier and more frequent attendance at antenatal clinics for essential check-ups and health education, as well as increased uptake of postnatal care for both mothers and newborns.
• Reduce financial burden on families: Eliminating out-of-pocket expenses for maternity care is intended to alleviate the financial strain on households, particularly those in lower socioeconomic brackets, and prevent delays in seeking care due to cost.  
• Decrease maternal and newborn mortality and morbidity: By improving access to quality care throughout the continuum of pregnancy, childbirth, and the postpartum period, the policy ultimately aims to reduce preventable deaths and complications for both mothers and their babies.
• Address geographical disparities: Accreditation of health facilities across the country, including those in remote and underserved areas, aims to ensure that quality maternity services are available closer to where women live.

Congruence with National Population Health Initiative: The “Linda Mama, Boresha Afya” initiative is highly congruent with Kenya’s national population health goals and objectives, particularly those outlined in the “Kenya Health Sector Strategic and Investment Plan (KHSSP)” and aligned with the Sustainable Development Goals (SDGs), specifically SDG 3 (Ensure healthy lives and promote well-being for all at all ages).  

• Goal Congruence: The policy directly supports the national goal of improving reproductive, maternal, newborn, child, and adolescent health (RMNCAH) outcomes and reducing health inequities. It prioritizes reaching vulnerable populations and ensuring universal health coverage (UHC) for essential maternal health services.
• Objective Congruence: The specific objectives of “Linda Mama” align with national objectives such as increasing the proportion of births attended by skilled health personnel, improving access to emergency obstetric and newborn care, and reducing the national maternal mortality ratio. By focusing on financial accessibility, the policy directly tackles a key barrier identified in national health strategies. Furthermore, its emphasis on quality of care and facility accreditation contributes to broader national efforts to improve the overall quality of healthcare services.

Proposed Strategy to Address the Health Risk/Disparity:

To further address the maternal mortality disparity in Kenya, a complementary strategy focusing on strengthening community-level health systems and empowering community health workers (CHWs) is proposed. This strategy would involve:

• Enhanced Training and Resources for CHWs: Providing CHWs with comprehensive training on maternal and newborn health, including early identification of pregnancy complications, health promotion messages, and referral pathways to formal health facilities. Equipping them with essential supplies and tools (e.g., mobile health applications for data collection and communication).
• Active Community Outreach and Education: Supporting CHWs to conduct regular home visits and community outreach activities to educate women and families on the importance of early antenatal care, skilled birth attendance, postnatal care, and recognizing danger signs during pregnancy and childbirth. This can help address issues of health literacy and cultural practices that may hinder access to care.  
• Strengthening Referral Linkages: Establishing clear and efficient referral systems between CHWs, primary healthcare facilities, and higher-level hospitals to ensure timely access to emergency obstetric care when needed. This includes providing CHWs with the means to facilitate transportation or communicate urgent cases effectively.
• Community Engagement and Participation: Involving community leaders, men, and other influential figures in maternal health awareness campaigns to foster a supportive environment for pregnant women and challenge harmful cultural norms.
• Integration with “Linda Mama”: Ensuring that CHW activities are well-coordinated with the “Linda Mama” initiative by providing them with information on the free services available and supporting women in accessing these services.  

This strategy complements the “Linda Mama” policy by proactively reaching women in their communities, addressing socio-cultural barriers, and facilitating timely access to the free services provided by the national policy. By strengthening the community-level health system, it can contribute to a more equitable distribution of quality maternal healthcare and further reduce the existing disparities in maternal mortality.

Last Completed Projects