ArticleThe International journal of health planning and management2021
Examining the implementation of the Linda Mama free maternity program in Kenya.
Article in The International journal of health planning and management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Facilitators and barriers of healthcare financing modalities for universal maternal healthcare services in East Africa: a qualitative systematic review.BMC health services research · 2025Pooled it
- The impact of digital interventions on health insurance coverage for reproductive, maternal, newborn and child health services utilization in Kakamega, Kenya: a cluster randomized controlled trial.Health policy and planning · 2024Trial
- Benefits and challenges of voucher-based transport for skilled birth attendance in Kitui County, Kenya: the health stakeholders' perspectives.BMC health services research · 2026Article
- Optimal design for matched pair cluster randomized trials with heterogeneous correlations and costs.Journal of applied statistics · 2026Article
- Institutional design features of health insurance subsidy programmes in Africa: a narrative review.International journal for equity in health · 2025Review
- Who remains uncovered? Assessing inequalities and determinants of national health insurance enrolment among informal sector workers in Kenya.Global health research and policy · 2025Article
- A qualitative study of perceived facilitators and barriers to adoption of continuous quality improvement in Western Kenya using the Consolidated Framework for Implementation Research (CFIR).BMC health services research · 2025Article
- A Systematic Review of Government-Led Free Caesarean Section Policies in Low- and Middle-Income Countries from 2009 to 2025.Healthcare (Basel, Switzerland) · 2025Review
- Article
- Community perspectives on access to maternal health services during the COVID-19 pandemic in rural Western Kenya: a qualitative study.BMC health services research · 2025Article
- Countdown to 2030: overview of current and planned health financing reforms for universal health coverage in the WHO African Region.Journal of global health · 2025Article
- Article
- Women's experiences with continuity for effective coordination during maternal and neonatal continuum in Kenya: An interpretive phenomenology.African journal of primary health care & family medicine · 2024Article
- Article
- Task sharing for increasing access to obstetric ultrasonography: a formative qualitative study of nurse-led scanning with telemedicine review in Kenya.Oxford open digital health · 2024Article
- Using knowledge translation to support the use of evaluation findings: A case study of the linda mama free maternity program in Kenya.PLOS global public health · 2024Article
- A mixed methods study on continuity and care coordination based on the obstetric near miss approach.Health SA = SA Gesondheid · 2024Article
- Policy formulation and actor roles in the expanded Kenyan free maternity policy (Linda Mama): A policy analysis.PLOS global public health · 2024Article
- The Effects of Ghana's Free Maternal and Healthcare Policy on Maternal and Infant Healthcare: A Scoping Review.Health services insights · 2024Article
- Can "the expanded free maternity services" enable Kenya to achieve universal health coverage by 2030: qualitative study on experiences of mothers and healthcare providers.Frontiers in health services · 2024Article
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Authors and funding
8 authors.
Funding
Abstract
backgroundIn 2013, Kenya introduced a free maternity policy in all public healthcare facilities. In 2016, the Ministry of Health shifted responsibility for the program, now called Linda Mama, to the National Hospital Insurance Fund (NHIF) and expanded access beyond public sector. This study aimed to examine the implementation of the Linda Mama program.
methodsWe conducted a mixed-methods cross-sectional study at the national level and in 20 purposively sampled facilities across five counties in Kenya. We collected data using in-depth interviews (n = 104), administered patient-exit questionnaires (n = 108), and carried out document reviews. Qualitative data were analysed using a framework approach while quantitative data were analysed descriptively.
resultsLinda Mama was designed and resulted in improved accountability and expand benefits. In practice however, beneficiaries did not access some services that were part of the revised benefit package. Second, out of pocket payments were still being incurred by beneficiaries. Health facilities in most counties had lost financial autonomy and had no access to reimbursements from NHIF for services provided; but those with financial autonomy were able to boost facility revenue and enhance service delivery. Further, fund disbursements from NHIF were characterised by delays and unpredictability. Implementation experiences reveal that there was inadequate communication, claim processing challenges and reimbursement rates were deemed insufficient.
conclusionsOur findings show that there are challenges associated with the implementation of the Linda Mama program and highlights the need for process evaluations for programs to track implementation, ensure continuous learning, and provide opportunities for course correcting programs' implementation.
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