June 4, 2013

Summary

Government moves to offer free maternity care, can it deliver? Around 40% of births are presently conducted without professional help. This move could change that, boosting infant survival rates country-wide.

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Government moves to offer free maternity care, can it deliver?

Government moves to offer free maternity care, can it deliver?

Following President Uhuru Kenyatta’s declaration that the maternity fee would be scrapped from June 1, maternal healthcare in Kenya is expected to be accessible to every woman, even those in marginalized areas.

HOME BIRTHS

Prior to this development in maternal health, according to the last Kenya Demographic and Health Survey 2008/2009, more than half of the about 1.5 million (56 per cent) women who give birth annually in Kenya give birth at home, with only 40 per cent reported to have been assisted by a certified medical practitioner.

Home deliveries, especially those carried out by ill -trained and ill-equipped midwives, increase the chances of complications for a mother and the unborn child hence increasing both maternal and child mortality rates.

The home deliveries, also referred to as home births, are more common in rural areas than in towns. 63 per cent of births in rural areas are delivered at home, compared to 25 per cent in towns. Under the Millennium Development Goals for Health, the government aims to reduce by three quarters (75 per cent) between 1990 and 2015 the maternal mortality ratio which currently stands at 488 per 100,000 live births.

Home births have also been cited as a key factor that may derail the country from achieving the UN global plan of ensuring that no child is born with HIV by 2015.

JUBILEE PROMISES BUT CAN HOSPITALS DELIVER?

In their manifesto, the Jubilee government promised that in the first 100 days of office, among other things, maternity will be free to all women in Kenya.

“Within the first one hundred days, we will ensure that maternity fees are abolished and that all citizens of Kenya are able to access government dispensaries and health centers’ free of charge”, said Uhuru Kenyatta

There has however been confusion in public hospitals as mothers go to deliver expecting free services only to be told that they have to pay the normal delivery charges with doctors claiming that they are yet to receive any circulars on the issue at hand.

In some hospitals it’s alleged that mothers are not being charged for deliveries but are being asked to buy supplies like medicine and gloves.

Stakeholders in the health sector are also raising questions on the viability of free maternity care especially where the operational costs of the medical centers is concerned since most hospitals earn at least one fifth of their revenues from maternity charges.

Another concern is that most public hospitals are still understaffed and ill equipped and will not be able to handle the influx of expectant mothers flocking in for free deliveries.

GOOD START BUT MORE TO BE DONE

The move to offer free maternity services and free health services in public institutions is without a doubt a step in the direct direction and will go a great way in reducing the high maternal and child mortality rates witnessed in Kenya but there is still much to be done at the primary level, like hiring and training of more medical practitioners especially obstetricians and midwives, an immense health infrastructure expansion and an increase in the funding allocated to the health sector.

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