Below is a comparison of maternity packages for Linda Mama,SHA and NHIF:
Maternity access under SHA:
Service:
Normal Delivery (all levels) & Caesarean Section (some level 3, and levels 4-6)
Fund:
SHIF
Access point:
Level 2-6 facilities
Fees:
Normal deliveries = Kshs 10,000
Caesarean Section = Kshs 30,000
Access Rules:
To access services under the SHIF you MUST be a contributor. This is a key bottleneck for maternity services for vulnerable women…who are a significant proportion of Kenya. Economic disenfranchisement of women is still real.
Notes:
The operation of the SHIF at Level 2-3 is legally irregular, but, it’s okay it can be argued that breaking the law to save lives is the lesser evil.
Service 2 under SHA:
Antenatal and postnatal care.
Fund:
PHC fund
Access Point:
Available at Level 2,3 and “select” level 4. Not covered at some level 4, and all level 5 &6
Fees:
No direct reimbursement – calculated as part of primary healthcare.
Access Rules:
Registration only, no need to contribute (however, this is not the case practically you need to show you’re contributing)
Notes:
ANC and PNC are falling behind. Patients incur costs due to the PHC funding model and lack of access to the service at level 4-6.
SHA new improvement
Anti-D now covered at 6,000
LINDA MAMA
Services scope:
Normal Delivery (levels 2-6)
Caesarean Section (some level 3, level 4-6)
Fees:
Normal deliveries = Kshs 3,500 (level 2 and 3). Kshs 6,000 (level 4-6)
Caesarean Section = Kshs 17,000 (Private and FBO) and Kshs 10,000 (public facilities)
Access Rules:
No contribution – free for all Kenyan women with proof of birth in Kenya or citizenship.
Antenatal and Postnatal care:
Covered 4 ANC and 4 PNC visits at Kshs 500 per visit.
Notes: Linda Mama removed barriers to access to Maternity care. Reimbursement was lower. In the end suffered lack of funds from National Treasury/MoH.
NHIF MATERNITY PACKAGE
Access Rules:
Must be an NHIF contributor or a registered dependant (Kshs 500 per month for self employed)
Access Points:
All levels 2-6
Services:
Normal Delivery: all levels at Kshs 10,000
Caesarean Section: Some level 3, all levels 4-6 at Kshs 30,000.
SHA Self inflicted bottlenecks:
Since July, SHA/Digital Health Agency has erased many level 2 and level 3 maternity beds. This was ostensibly because as per SHA those KEPH levels (2, 3B) are “outpatient facilities” and should not have any bed capacity, including delivery/labour beds. This is a mistake
CONCLUSION:
Which is better? Be the judge. SHA Maternity cover is basically NHIF Maternity cover in all but name. However SHA has Compulsory contributions for eligibility.
Linda Mama targeted vulnerable women (poor or needy). There is nothing similar to Linda Mama under SHA.
