By Evance Odhiambo
Maternal health remains a major health challenge in sub-Saharan Africa (SSA). In Kenya, the Maternal Mortality Ratio (MMR) was 362 deaths per 100,000 live births according to the statistics by the ministry of health.
This among other maternal health challenges has changed since the introduction of Linda Mama program operated by National Hospital Insurance Fund (NHIF). The program that has been running since 2017 in both public and private hospitals has so far yielded notable fruits according to testimonies by mothers, health facilities and the department of health in Kisumu County.
The program which offers free maternal services from antenatal care to delivery was initiated by the national government to ease access to maternal healthcare which used to be a big challenge because it was expensive.
According to Jackline Miwindi, a nurse handling maternity patients at Star Annex Hosiptal in Kisumu, expectant mothers, who must be above 18 years, are registered to Linda Mama program upon request at the initial stages of pregnancy.
‘’For expectant mothers under 18 years, they are registered using their guardians’ IDs and antenatal care records. Those without ID or guardians can be registered using antenatal care records,’’ says Miwindi.
She says that all expectant women who are Kenyans are eligible and registration can be made online on NHIF portal or through mobile phone by dialing *263# and following the menu given.
‘’The registration is done in hospitals by healthcare providers, NHIF service centers and Huduma centers countrywide,’’ says Miwindi.
Lillian Atieno, a nurse in-charge of the Maternity wing, said that the hospital has experienced tremendous increase in the number of deliveries since Linda Mama began.
‘’Right now our three maternity wards are full and we have created a space with beds at the reception. Many women are now coming to deliver at the health facility. This was not the same before 2017,’’ says Atieno.
Kisumu County Director of Health Dr. Fred Oluoch said that there has been a 24% increase in the number of women delivering in health facilities in Kisumu We are even putting more effort through the County’s health scheme dubbed Marwa that offers affordable health service. I am sure we will clock over 30% this year,’’ says Dr. Oluoch.
Brilliant Awuor from Kajulu in Kisumu East has used the program twice and says it catered for all the services from antenatal care to delivery.
Just like at Kisumu County Referral Hospital, Linda Mama is lauded in other private hospitals in Kisumu. A visit at Dunga Nursing Home, Kowino Health Center, Kuoyo Health center among others reveal the same narrative of improved maternal healthcare, thanks to Linda Mama.
Pamela Awuor, a mother of five in her 60s living in Obunga informal settlement, however did not use Linda Mama during her child bearing time since she got her last born in 2008 years before the program was initiated in 2017.
She says that getting maternal healthcare was a big challenge during her time. She narrates that she depended on traditional midwives whose services were very risky in case of complications.
‘’During our time, giving birth was a serious challenge. We did not have access to better healthcare programsbeing enjoyed now. All my five children were born at home. I occasionally attended clinics and since they were expensive, I stopped,’’ says Awuor.
Mereza Akoth who is in-charge of Billing and NHIF office at Kisumu County Referral Hospital however noted some challenges that come along with the program. She noted disparities of Identification Cards as the main challenge.
Akoth said that some mothers who visit the facility to deliver tend to us IDs of their relations and this hinders the remittance of funds by NHIF.
She also said that referrals from other health facilities in cases of complications is making them loose Linda Mama remittances. She said that the hospitals referring mothers continue to submit details to NHIF and receive payments as opposed to them who complete the entire delivery process.
The department of health at the Kisumu County Government also feels the limitations of the program. Dr. Oluoch, the Director of Health at Kisumu County, noted that delays in remittance of Linda Mama funds occasionally forces them to chip in and allocate finance to cater for the patients, and receive payment later from NHIF. Nevertheless, he noted that the program is a milestone in healthcare in Kenya. He said that this program is sustainable and can be replicated in other countries.
According the ministry of health, Linda Mama has so far reached over 5 million women and maternal fatality reduced by 43%.