The realities of free maternity care for underprivileged women in Kenya.


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I was seated in my office immersed on a pile of papers when Mary (not her real name) walked in. From her face you could tell that she was tired though happy. I immediately offered her a seat and once she had gracefully taken a seat we exchanged pleasantries. It was a pleasant surprise to see her soon and even more to see her with a baby. Mary had been to my office a few days prior and was heavily pregnant then. Curious, I asked her when she had delivered to which she replied, “Yesterday”. I was quick to compliment her for the milestone and the strength to walk around after being discharged from the hospital so quickly. Mary corrected me that she had delivered at home all by herself. I was taken aback but Mary had no qualms. She seemed to be at ease with herself giggling while covering her face using a leso. Shocked, I chastised her for not going to the nearby healthcare facility to deliver. I even went on to tell her that maternity services are free, and she therefore had no excuse for putting herself and the child at such risk. Mary bowed her head in shame and she paused for a while before gathering courage to explain herself.

“It is true that maternity services are free. However, they are only free in government health facilities. Unfortunately, my one room abode is not close to any government health facility…” she said. All this while, I was pensively listening that I didn’t notice she had stopped talking. Then Mary begun sobbing and this pierced through my heart as I thought how insensitive I was. Mary opted to deliver at home for fear of not making it to hospital in time. She also stated that the private clinic near her house would require her to carry her own razorblade and other items which she could not afford.

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I tried to calm Mary and assured her that all shall be well. I gave her time to ventilate. This time I was not judgemental having realized that all this while I had been addressing her from a point of privilege and got off my high horse. I was embarrassed by how quickly I had jumped into conclusions and overlooked factors that would make access to this service difficult. In my mind, because the government offers free maternity services, it should not be too difficult to access the services when needed. The reality is that as much as free maternity is available, the service is not accessible to everyone.

Just like Mary, many women are unable to access the free maternity care because they are not in every health facility. Where one lives far from a government facility, they are out of lack. Labour does not always go as planned and may begin suddenly leaving those who rely on government clinics but live a distance from one, to their own devices.

There is no doubt that having free maternity services for expectant mothers is an excellent initiative. However, there needs to be more effective effort made to ensure that all women have equal access to these services. The mobile clinics that were part of the free maternal health initiative need to be implemented to the letter. Failure to which many other women will end up in Mary’s situation. This exposes them to risks of infection where the environment is not sterile or even result in a fatality where complications arise.