PS Muthoni: Linda Mama is coming back, bigger and better

Maternal deaths continue to be a major public health problem in Kenya.

A recent report by the United States Agency for International Development reveals that the country has a maternal mortality rate of 594 deaths per 100,000 live births, ranking fourth in Africa.

Poverty-related maternal mortality has long been a public health concern in Kenya, prompting the launch of the Linda Mama scheme in 2013 under the leadership of former President Uhuru Kenyatta. This programme was designed to provide free maternity services in public health facilities, reducing financial barriers to healthcare. 

In 2016, the government transitioned these services to the now-defunct National Health Insurance Fund (NHIF) and expanded coverage to include private health facilities, further, rebranding it to the Linda Mama Programme.

 The programme was administered through NHIF but as a standalone initiative funded by the government, World Bank and Japan International Cooperation Agency and targeted all pregnant if one possessed the Linda Mama card. 

“I got my two children through the initiative— in 2017 and 2019 consecutively. Then, I wasn’t a registered member of NHIF as I couldn’t afford it.  When my last born turned six months, I was screened for cervical cancer and offered a family planning method, without paying for any of the services,” offers Alice Wanja, a past user of the programme. 

Last year, the government announced plans to replace NHIF with a new social health scheme—the Social Health Authority (SHA). The SHA consists of three subsidiary funds: the Primary Healthcare Fund, the Social Health Insurance Fund (SHIF), and the Emergency and Chronic Illnesses Fund (ECIF). 

One of the key benefits of SHIF is maternal care, but to access services, one must be a registered and paid-up member. However, the SHA’s future is currently uncertain as the Social Health Insurance Act (SHIA) 2023, which established the SHA, was declared null and void by a three-judge bench, and the matter remains in court. 

Since the announcement of the new social health scheme, many Kenyans have expressed dissatisfaction and called for the return of the ‘Linda Mama’ programme, describing it as a lifeline for women who cannot afford maternity services. Data from NHIF in 2023 shows that more than 5.2 million mothers had been registered under the programme, with an average of 1.2 million mothers benefiting annually since the launch. 

Health Principal Secretary Mary Muthoni has responded to these concerns, confirming that Linda Mama will return, this time “bigger and better.” She emphasised that the government has listened to the public and is committed to enhancing the programme. 

When asked about the operationalisation of the initiative under the new social health scheme, PS Muthoni said the following:

Is Linda Mama coming back?

Yes, I want to confirm that it is coming back. This time, bigger and better. We are a listening government. We hear and what we go to is public participation. When people tell us that is what they want, then it is packaged together. The programme will be integrated in the social health insurance. It will be a programme just like it was, helping the mothers and children.

The reimbursement to health facilities will be close to Sh11,000 for normal delivery and Sh32,000 for caesarean section. This has been revised upwards from the previous scheme that paid just Sh4,000.

Who will cover these costs?

The benefits under Linda Mama will be covered by the Primary Healthcare fund and financing from SHIF.

What will the package cover?

The package will cover prenatal care, normal delivery, caesarean and newborn care and equally if there are complications, we will cover that. What we are doing now is repackaging the same and enhancing the benefits.

The exchequer is meant to cover services under the Primary Health Care fund, ECIF and those who cannot afford to pay the minimum contribution of Sh300. In which category will expecting women fall under?

The exchequer and SHIF will cover everyone. It is the social health authority that will appropriate the funds that will go into Linda Mama and what will go into SHIF.

For delivery, just present yourself - whether it’s normal or caesarean section.

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