The Social Health Authority (SHA) has introduced a new policy to ensure that all expectant mothers receive essential maternal health services, even if they have not fully paid their contributions.Â
In a letter to all contracted facilities offering Primary Health Care (PHC), Robert Ingasira, chairman of SHA said that the initiative is a critical step in reducing maternal and perinatal deaths, while improving healthcare access and equity for women, particularly those who face financial challenges.
Under this directive, these facilities are required to provide comprehensive maternal healthcare services to registered beneficiaries, including antenatal care, delivery services, postnatal care and treatment for complications arising during pregnancy, childbirth, or postpartum.
“In view of the above, therefore, this is to inform all contracted PHC facilities that they are required to provide maternal healthcare services to expectant mothers seeking maternal healthcare services in their facilities,” said Mr Ingasira.
The policy further mandates that all PHC facilities must treat expectant mothers registered with the SHA, even if their contributions are not fully paid, ensuring that financial constraints do not prevent women from accessing vital maternal health services.Â
Facilities are required to treat these patients under the same guidelines as all other SHA beneficiaries, eliminating any form of discrimination due to non-payment of contributions.
“... kindly note that all expectant women seeking antenatal care, delivery services, postnatal care and any complications arising from pregnancy or maternity, should not be denied service at your facility, provided they are registered with SHA,” said Mr Ingasira in the letter.
To support PHC facilities in providing these services, SHA has allocated dedicated funds and established a reimbursement mechanism to ensure sustainability.
Antenatal and postnatal care will be reimbursed through outpatient capitation based on gazetted rates, which will cover Sh900 per beneficiary per year, while delivery services, including normal and caesarean deliveries, will also be reimbursed based on gazetted rates, which will cover Sh10,000 and Sh30,000 per year respectively.Â
For complications requiring hospitalisation, reimbursement will follow gazetted rebates aligned to the Kenya Essential Package for Health levels.
Mr Ingasira noted that the initiative has the potential to significantly improve maternal and perinatal health outcomes, by providing timely access to skilled care during pregnancy, childbirth and the postpartum period, while the structured reimbursement mechanism motivates PHC facilities to maintain high standards of care while expanding their capacity to serve more patients.
