Experts on maternal health have urged the government to take further steps in order for the presidential directive on free maternity services to be more effective.
The recommendations include timely reimbursements to health facilities, the adequate equipping of the facilities and an increase in the numbers of health workers.
The meeting, held at a Nairobi hotel on Thursday, 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 the country are recording numerous deaths of mothers from pregnancy-related causes. Prof Rogo cited Mandera county, where he said 3,700 women die every year from childbirth or pregnancy-related causes.
"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," he said.
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 is 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 also noted as a major problem. Dr John Ong’ech, a senior official at the 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 issue was highlighted by Kisumu health executive, Dr Elizabeth Ogaja, who said delays in reimbursements are affecting the implementation of the directive in many facilities in the 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 Kenyans 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 would not deliver the expected results.
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 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.