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Perspectives of stakeholders of the free maternity services for mothers in western Kenya: lessons for universal health coverage

Ochieng, Beverly Marion; Kaseje, Margaret; Kaseje, Dan Clement Owino; Oria, Kevin; Magadi, Monica


Beverly Marion Ochieng

Margaret Kaseje

Dan Clement Owino Kaseje

Kevin Oria

Monica Magadi


Background: The strategic aim of universal health coverage (UHC) is to ensure that everyone can use health services they need without risk of financial hardship. Linda Mama (Taking care of the mother) initiative focuses on the most vulnerable women, newborns and infants in offering free health services. Financial risk protection is one element in the package of measures that provides overall social protection, as well as protection against severe financial difficulties in the event of pregnancy, childbirth, neonatal and perinatal health care for mothers and their children. Purpose: The aim of this study was to find out the extent of awareness, and involvement among managers, service providers and consumers of Linda mama supported services and benefits of the initiative from the perspectives of consumers, providers and managers. Methods: We carried out cross sectional study in four sub counties in western Kenya: Rachuonyo East, Nyando, Nyakach, and Alego Usonga. We used qualitative techniques to collect data from purposively selected Linda Mama project implementors, managers, service providers and service consumers. We used key informant interview guides to collect data from a total of thirty six managers, nine from each Sub -County and focus group discussion tools to collect data from sixteen groups of service consumers attending either antenatal or post-natal clinics, four from each sub county, selecting two groups from antenatal and two from postnatal clinics in each sub county. Data analysis was based on thematic content analysis. Findings: Managers and service providers were well aware of the initiative and were involved in it. Participation in Linda Mama, either in providing or using, seemed to be more prominent among managers and service providers. Routine household visits by community health volunteers to sensitize mothers and community engagement was core to the initiative. The managers and providers of services displayed profound awareness of how requiring identification cards and telephone numbers had the potential to undermine equity by excluding those in greater need of care such as under-age pregnant adolescents. Maternity and mother child health services improved as a result of the funds received by health facilities. Linda Mama reimbursements helped to purchase drug and reduced workload in the facility by hiring extra hands. Conclusion: The initiative seems to have influenced attitudes on health facility delivery through: Partnership among key stakeholders and highlighting the need for enhanced partnership with the communities. It enhanced the capacity of health facilities to deliver high quality comprehensive, essential care package and easing economic burden.


Ochieng, B. M., Kaseje, M., Kaseje, D. C. O., Oria, K., & Magadi, M. (2022). Perspectives of stakeholders of the free maternity services for mothers in western Kenya: lessons for universal health coverage. BMC health services research, 22(1), Article 226.

Journal Article Type Article
Acceptance Date Feb 11, 2022
Online Publication Date Feb 19, 2022
Publication Date Dec 1, 2022
Deposit Date Apr 1, 2022
Publicly Available Date Apr 1, 2022
Journal BMC Health Services Research
Print ISSN 1472-6963
Electronic ISSN 1472-6963
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 22
Issue 1
Article Number 226
Keywords Universal Health Coverage; Maternity; Skilled Delivery; Ante Natal Care; Post-Natal Care; Quality Care; Cost Effectiveness; Social Protection
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Copyright Statement
© The Author(s) 2022.
Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons. org/licenses/by/4. 0/. The Creative Commons Public Domain Dedication waiver ( zero/1. 0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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