Fearure: Kenyan women still face challenges despite free maternity service

Rachel Mukami takes a few minutes off braiding her client at a salon in Eastmore suburbs, east of Nakuru town in the Rift Valley; to breastfeed her 11-week-old son.

"He has to cope with me lest he lacks milk to feed on," the rather shy young mother told Xinhua on Saturday.

In ideal circumstances, Mukami would be resting at home to take care of her first born child. But it is the push to have not just food but a balanced diet for her child that she has been pushed into the salon albeit on casual terms, a lack that mirrors the state under which she gave birth.

"I only had two U.S. dollars in the house when I went into labour. That is what my friend used to pay a taxi to rush me to PGH (Nakuru County Referral Hospital)," said Mukami, who says she doesn't have a National Hospital Insurance Fund (NHIF) card.

NHIF is a State insurance fund under which citizens both employed and self-employed make monthly contributions to cover for their medical needs.

With the card, the members can be attended to in both public and private hospitals which have signed agreement with NHIF management to offer the services.

Her husband who works as a tout was away at the time of her labour and they did not have any savings in the house, she says.

"I was afraid doctors would chase me away since I didn't have money but thank God I delivered without any charge. Only that my friend told me she had spent her money to buy me some essentials I needed for the birth," she said.

"If it wasn't for that free maternity service I would have opted for a mid-wife. We do have an elderly Sudanese woman around here helping with delivery only that she cannot handle complications."

Esther Moseti, a grocer at Whitehouse, east of the outskirts of Nakuru town is in her second trimester and she is ready for her child.

"When I was carrying my firstborn now 19 years, I was worried about the hospital charges. But (President) Uhuru said we give birth for free, I am not worried," she said with a laughter.

"You can have a headache thinking about the expenses involved .I am happy it is free although I am yet to visit public hospital to know how free it is but am told it is free as per the word of those who have given birth (since introduction of free maternity services in 2013)," said Moseti who also lacks the NHIF card.

Mukami and Moseti boast of the government's initiative to lift the weight of charges paid on delivery in the public hospitals.

Health functions in Kenya have been transferred to the counties which are implementing the free maternity program introduced by the national government to reduce deaths of mothers and children during or immediately after delivery.

The policy was informed by high maternal deaths resulting from women shying away from hospitals due to the fees that they would hardly afford.

Initially counties covered for the deliveries and invoiced the national government for reimbursement. The mothers did not need to have the NHIF cards, the favourable condition under which Mukami managed to deliver her son.

But things will be different for Moseti. The ministry of health will now be reimbursing the county governments indirectly through the NHIF, making it a compulsory that Moseti acquires the card to be counted.

"Is that the case again?" asked Moseti as she held her chin.

"Now there is a problem. I have always wanted to go for the card (NHIF) but where is the money. I am struggling to raise fees for my son to join college. I have nothing else to say if that is what is going to happen," she retorted.

The self-employed are required to remit a minimum of five dollars monthly to the State insurance fund from the previous 1.6 dollars. The new rates came into effect on April 2015.

Mukami and Moseti fall into the frame of thousands of Kenyan women faced with distinct challenges to enjoying motherhood.

Lack of better means of survival, harsh economic conditions and yearn to provide their basic needs stands on their way as indicated by the two women.

Despite all, the government shows improvement in access to health services including maternal health.

Health Cabinet Secretary Cleopa Mailu says as a result of free maternity services program deliveries in health facilities have doubled. They currently stand at 1.2 million from 600,323 in 2013, the health ministry indicates.

"Efforts to improve healthcare since 2013 have also contributed to major improvements in child and maternal health indicators.

Deaths of children below five years have declined from 74 to 52 per 1,000 live births and infant deaths from 52 to 39 per 1,000 live births," he wrote in a local daily on Oct. 5.

Maternal deaths have also reduced to 362 from 488 per 100,000 live births, he said.

The national government pays 25 dollars for each delivery at dispensary and health center, 30 dollars for Level Four and Five hospitals and 17.5 dollars for multi-level hospitals, fees which would otherwise be paid by the mothers. Endit