Effect of Health System Factors On Uptake and Utilization Of Linda Mama Initiative in Kajiado North Sub-County, Kenya

Abstract

Maternal mortality continues to pose a significant public health challenge, with over 300,000 women losing their lives annually during childbirth. In response, policymakers have implemented free maternal healthcare services as a crucial policy intervention. In June 2013, the Kenyan Government introduced the Linda Mama healthcare service, exempting maternal services from user fees across all public health facilities. The primary objective was to encourage skilled delivery and ultimately reduce pregnancy-related mortality. Despite these efforts only 26 percent of mothers In Kajiado North Sub-county aged 19 to 40 had enrolled for the Linda Mama service, falling below both the national average of 61.5 percent and the government's target of 100 percent. We conducted a study to investigate the barriers to uptake of the Linda Mama initiative and utilization of services offered under the initiative. The proportion of uptake of Linda Mama Programme, how socio-demographic, knowledge & perceptions and health system factors affect the uptake of the Linda Mama Initiative were the specific objectives. This paper presents findings from a cross-sectional study conducted between 2018 and 2020 in Kajiado North Sub-County, involving 551 participants. Descriptive statistics were employed, alongside the Chi-Square test for inferential statistics. Correlation analysis was used to explore how health system factors have influenced the uptake and utilization of the Linda Mama service. The results reveal that respondents were generally aware of the government's policy on free maternal healthcare. However, significant gaps persist in terms of infrastructure development, the ratio of health workers to patients, timely provision of essential supplies, and the long distances to health facilities. These findings underscore the urgent need for increased investment in infrastructure, as well as financial and human resource allocation to the healthcare sector within County Governments