Anti-Politics and Free Maternal Health Services in Kilifi County, Kenya

Abstract

Maternal healthcare is a global agenda. Kenya introduced free maternity services (FMS) in 2013 to allow women to give birth for free in all government public health facilities. The introduction of FMS was timely due to the high maternal mortality rate in Kenya. FMS was also introduced to fulfil the Jubilee Party government’s elections campaign promises. It is, however, not known how primary beneficiaries and health providers perceived the FMS roll-out following the presidential directive in 2013. This article aims to explore the roles of political contestations in FMS as a social protection scheme in Kenya. In this qualitative ethnographic study in Kilifi County, we interviewed the mothers who utilised FMS and the health workers who implemented the policy. The data gathered was analysed contextually and thematically. The prevailing narrative from the health services professionals and the mothers who participated in our study is that FMS is ‘the president’s thing’ and has a clear political orientation; it is seen as deceiving the public in two ways: first by shrouding political interests, and second by adding to the burden of women, as delivery was not free – all the other services and medication before and after birth came at a cost. Health workers feel helpless and frustrated and, in most cases, they have to cope with meagre resources to ensure safe births. In some cases, quality of care is compromised due to supply-side constraints. This article shows how social protection has been used to gain political mileage and has not considered the local needs of the maternal healthcare system.