April 30th, 2025

Kenya’s Vision 2030 and the current administration’s policy agenda prioritises universal health coverage, aiming to ensure all Kenyans receive the highest quality of care.

Despite the progress attained in the past few decades, maternal and neonatal health (MNH) remains a key healthcare challenge in Kenya. The latest data shows that Kenya’s maternal mortality ratio (MMR) was 530 deaths per 100,000 live births in 2020 (World Health Organisation) and the neonatal mortality rate 21 deaths per 1,000 live births (Kenya Demographic and Health Survey, 2022). Kenya’s maternal and neonatal mortality rates are significantly above the global averages despite the national Linda Mama programme and other efforts.

The ambition in addressing the maternal and neonatal mortality has been primarily to increase the volume of available and consumed healthcare, that is, building more healthcare facilities, training and hiring more nurses and doctors, prescribing and funding more medicine. However, based on research and evidence the quality of care is now the main driver of successful healthcare delivery and improved health outcomes.

FSD Kenya’s health finance work aims to facilitate and advocate for value adding finance that enables improved health and financial resilience to health shocks for women and households.

FSD Kenya has partnered with Britam Holdings Limited and the FSD Network Gender Collaborative Programme, to design and pilot a MNH value-based care programme which was launched in May 2024. The design incorporated insights from a User journeys study which sought to understand the pain points and how access to quality care could be improved.

Value-based care is a healthcare approach that focuses on delivering high-quality care at a lower cost by prioritising outcomes that matter most to patients. Its goal is to shift the healthcare system from a fee-for-service model, which incentivises providers to perform more procedures and services, to one that rewards providers for achieving better health outcomes for patients.

The expectation was that the pilot would improve maternal and neonatal health outcomes for the participating households, scalability of Britam’s AfyaTele health insurance solution, and cost effectiveness for healthcare providers. Thus far, Britam has partnered with 31 healthcare facilities within Nairobi and its environs for provision of care and Jacaranda Health. Jacranda Health’s PROMPTs, an artificial intelligence (AI)-enabled digital health service two-way SMS exchange, empowers women to seek care at the right time and place, and gives them greater agency in the health system. The system also collects feedback from the participants which has been useful in monitoring and improving the quality of care.

Eight months down the line, the pilot had reached over 1,100 expectant mothers and led to better MNH health outcomes above the national figures such as 29% caesarean sections and 61% spontaneous normal delivery (compared to 53% and 45% as per Kenya Health Information System), respectively. Generally, the mothers are happy with the care received under the programme, with a net promoter score of 9.4.

The value-based care approach presents an opportunity for providing quality healthcare at scale. It is our hope that the pilot will provide valuable learning, and this approach can adopted beyond MNH within Britam and by other players in the market, including the public health sector.

This blog is one of the articles in FSD Kenya’s 2024 annual report. Click here to read the full report (PDF).

TAGS

CATEGORIES