The third quarterly Maternal and Newborn Health (MNH) Technical Working Group (TWG) meeting was held on June 27, 2013 in Nairobi, with a focus on the delivery of free maternity services by the government and its development partners. The meeting was attended by senior government officials including the head of the Department of Family Health (DFH), Dr. Anna Wamae as well as various development and implementing partners working within the Reproductive Health Sector in Kenya.
The Government, through a presidential decree, announced that maternity services will be provided free of charge in all public health facilities in Kenya starting June1, 2013. The policy directive is expected to reduce inequalities in healthcare financial access as well as increase skilled birth attendance and improve maternal and newborn health outcomes. This is in turn expected to boost Kenya’s efforts to achieve a Maternal Mortality Rate (MMR) of 147 per 100,000 live births by 2015, as per the country’s Millennium Development Goal 5 target. The free maternity services package includes ante natal care, skilled birth attendance, postnatal care and all complications arising from pregnancy and delivery.
The head of the Division of Reproductive health, Dr. Issak Bashir, gave a presentation updating the stakeholders present on the delivery of free maternity services in all public health facilities in the country. In his presentation, he reported that the free maternity services initiative was being implemented by the government through reimbursement of public health facilities for the cost of maternity and related services. It was reported that utilization of maternity services in public health facilities had increased by 100 percent in the first week after the directive was announced on June 1, 2013. In response to this, the government has increased the number of skilled birth attendants in high volume hospitals such as Pumwani Maternity Hospital and the Kenyatta National Hospital, to address the high influx of patients to these hospitals.
However, concerns were raised over the quality of the free maternity services being offered given the current challenges facing the health system such as acute staff shortages, poor infrastructure and lack of equipment and supplies. In response, the head of DRH reported that the challenge of inadequate basic supplies and commodities was being addressed first through reimbursement of the cost of services offered by health facilities. He also called on development partners to contribute to the delivery of free maternity services through capacity building of service providers. This is expected to equip the service providers with the necessary skills needed to deliver quality free maternity services as well as generate buy in for the program among service providers.
In spite of the challenges facing the health system regarding implementation of the free maternity services policy directive, the government is committed to the provision of quality free maternity services in all public health facilities. The DRH will be convening a special TWG meeting to plan the implementation of quality maternity services with all stakeholders in the near future.
The TWG also discussed other on-going initiatives whose objective is to address the financial barrier to the access of skilled birth attendance, specifically the Output Based Approach (OBA) and the Global Fund to fight Aids, Tuberculosis and Malaria (GFATM), in the context of free maternity services. The OBA provides financing for agreed outputs rather than pre-defined inputs by selling vouchers for reproductive health and family planning services at subsidized prices to patients. The cost of the services provided is then refunded to service providers in the private sector (medical doctors, qualified nurses and midwives), government hospitals, NGOs (non-governmental organizations) and faith based organizations. The Programme is funded by the German Development Bank (KfW) and implemented by the Government of Kenya. Participants proposed that the OBA model continue to be used particularly to reimburse FBOs for services provided to the poor, particularly in areas that are not served by government health facilities. It was also proposed that the model be used to address poor geographical access to health facilities in rural areas through providing reimbursement for transport to hospitals.
The National AIDS and STIs Control Programme (NASCOP) also gave a presentation on a Programme to provide free maternity services in high HIV prevalence districts through the GFATM. Through this Programme, procurement of basic equipment for provision of skilled birth attendance is ongoing and the equipment will be distributed in high HIV prevalence districts.
The GIZ health sector program has been supporting the government to build the capacity of health care workers in five districts with the aim of improving access to reproductive health services for the poor. This support to health systems strengthening is part of GIZ’s contribution improving access to reproductive health in Kenya.2013-08-05
August 5, 2013
August 1, 2013
January 15, 2013
December 14, 2012