Barriers to Uptake and Utilization of Linda Mama Initiative Among Women of Reproductive Age (15-49 Years) in Kajiado North Sub-County, Kenya

Abstract

Maternal mortality remains a significant concern globally, with substantial improvements observed over the years yet persisting challenges, particularly in resource-constrained regions like Kenya. From 2000 to 2018 according to the World Health Organization (WHO), approximately 295,000 women died during and following pregnancy and childbirth in 2017. Kenya, like many countries in sub-Saharan Africa, faces challenges in reducing maternal mortality rates despite efforts to improve maternal healthcare services. According to the Kenya Demographic and Health Survey (KDHS) 2014 estimates, Kenya's maternal mortality ratio (MMR) was 362 maternal deaths for every 100,000 live births. In Kajiado North Sub-County, Kenya, despite governmental efforts such as the Linda Mama program, aimed at sponsoring maternal care services to alleviate financial burdens on expectant and pregnant women, uptake and utilization of these services remain low. This study, conducted between 2018 and 2020, targeted childbearing mothers aged 15-49 in Kajiado North Sub-County, with a population of 310,696. The study employed inferential statistics, specifically chi-square tests, to reveal significant relationships between socio-demographic factors, health system factors, and the uptake of the Linda Mama Initiative, with p-values less than 0.05. It was found that only 26% of women had registered for the initiative, a figure significantly lower than the national target, despite high levels of knowledge and positive perceptions of the program. The analysis further demonstrated that health system factors, such as infrastructure and support from health workers, had a more substantial impact on the uptake of the initiative compared to socio-demographic factors. Findings indicate that the Linda Mama Initiative program is accessible and straightforward, with easy enrollment processes primarily conducted in health facilities and minimal paperwork requirements. Information dissemination about the initiative is facilitated through various media channels, including social media, radio, television, and community forums like Chief's Baraza. The study underscores the importance of promoting the utilization of Linda Mama initiative services, emphasizing their accessibility, affordability, and critical role in safeguarding the health and well-being of mothers and newborns. The study recommends policymakers to improve infrastructure and possibly increase funding. Implementers should make use of social media for dissemination, expand insurance coverage and involve local leaders for credibility.