Providing free maternity services in Kenya’s public health facilities is enabling more women to deliver with the care of trained health workers. However, for this presidential directive to save more lives of Kenyan women, the government must ensure timely reimbursements to health facilities, adequately equip health facilities, and increase the numbers of health workers.
These were among the key recommendations made by experts on maternal health who met in a breakfast meeting at the Silver Springs Hotel in Nairobi on February 12, 2015. The meeting was organised by the Ministry of Health and the African Institute for Development Policy (AFIDEP).
Prof. Khama Rogo, a leading reproductive health expert in Kenya who chaired the meeting, noted that while the free maternity services policy has increased access to services, some regions in Kenya are recording very many deaths of mothers from pregnancy-related causes. Prof. Rogo cited Mandera county, where he said 3,700 women die every year from child-birth or pregnancy-related causes.
He said, ‘when I heard the Kenyan government was sending health workers to Liberia to help fight Ebola, I really wished they could also send health workers to Mandera to provide services to Wanachi’.
The problem of few health workers especially in rural and remote regions was mentioned as one of the challenges despite maternal service being free, there’s a shortage of health workers to provide them.
Dr. Leah Kirumbi, a researcher from KEMRI, challenged the government to pay health workers well and provide special remuneration packages for health workers deployed in remote and challenging regions like Mandera.
The issue of delayed and inadequate reimbursements to health facilities was noted as a major problem. Dr. John Ong’ech, a senior official at Kenyatta National Hospital said that many times the reimbursements to health facilities are delayed and do not cover all the costs incurred in providing free maternity services.
This challenge was highlighted by Kisumu County Health Minister, Dr. Ogaja, who said delays in reimbursements are affecting the implementation of the free maternity services in many facilities in her county.
Dr. Eliya Zulu, Executive Director of AFIDEP, called on Kenya to take advantage of the political support for maternal health both by the president and first lady to ensure that the poorest Kenyan can get services.
“Many African countries are struggling to get political support for maternal health like what Kenya has, so we must take advantage of this and ensure services are available,’ he said.
The other problem highlighted was the poor quality of services in public health facilities. Participants at the breakfast meeting said that unless we have enough health workers, equipment and medical supplies in all health facilities, the free maternity services directive will not return much results.
In summing up the event, Prof Rogo called on the government to change the financing of the free maternity services and give vouchers to women who should then get services from the facilities of their choice.
He also called for the involvement of more stakeholders including women and other sectors, in the implementation of the free maternity services so that it is not just a Ministry of Health affair.
Finally, he advised that the implementation of the free maternity services directive should be evaluated periodically to understand its successes and failures.