How maternal health trial halved miscarriages, slashed re-admissions
Health & Science
By
David Njaaga
| Oct 03, 2025
A maternal health pilot in Kenya has halved miscarriage rates and reduced post-delivery hospital admissions by 73 per cent.
The findings, published in the Lea Mama value-based care pilot report, point to a shift in how maternal and neonatal care is delivered, moving away from access alone to the quality of care received.
Kenya records 355 maternal deaths per 100,000 live births and 21 neonatal deaths per 1,000, far above the 2030 Sustainable Development Goals targets of 70 and 12, according to the World Health Organisation.
Kenya’s maternal and neonatal health sector continues to face pressure to deliver better outcomes despite years of investment in infrastructure, training and free maternity programmes.
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Public initiatives such as Linda Mama have expanded access to skilled birth attendance, which rose from 66 per cent in 2014 to 89 per cent in 2022, according to Ministry of Health data.
However, mortality rates remain above global targets.
The Lea Mama pilot report noted that more than 80 per cent of maternal deaths in low- and middle-income countries are linked to poor quality of care rather than lack of access, citing WHO findings.
It added that Kenya’s reliance on the fee-for-service model, which pays providers based on volume of services, may have contributed to fragmented care and poor outcomes.
At the same time, Kenya’s push for universal health coverage has expanded financial access through both public and private insurance schemes, including microinsurance products targeting low-income groups.
The report said these schemes have exposed weaknesses in care coordination, data reporting and provider incentives despite widening coverage.
The Health Act and Kenya Health Policy 2014–2030 call for more efficient, equitable, and outcome-driven care, but the report observed that implementation has been uneven across counties.
This has prompted interest in value-based care models that link payments to health outcomes rather than procedures.
“Such models aim to reduce preventable complications, shorten hospital stays, and improve patient experience,” the report said.
The pilot, dubbed Lea Mama, was designed by Financial Sector Deepening (FSD) Kenya in partnership with diversified financial services group, Britam.
It was launched in May 2024 under Britam’s Afya Tele microinsurance product and tested in Nairobi, Kisumu, and Murang’a counties.
Hospitals participating in the pilot used Patient-Reported Outcome and Experience Measures to track both clinical and non-clinical outcomes, including blood pressure monitoring, foetal heart rate tracking, and patient feedback.
“The inability to access the right quality and kind of care promptly had a knock-on impact on the health outcomes, leading to extended hospital stays for mothers and neonates and re-admissions,” the report said. “Treating expectant mothers with respect has been shown to impact maternal and neonatal health outcomes in other programmes."
“All the mothers interviewed during the study had attended the recommended four antenatal care visits,” the report observed, adding, “The value of care varied considerably in breadth, quality, and timeliness.”
“Non-clinical aspects of the care, such as how the mothers were treated, were also reported as crucial. Generally, the mothers were happy with the care received under the programme,” it noted.
According to the findings, the programme now aims to expand to more counties while engaging the Ministry of Health and insurers on how outcome-based payments could be incorporated into Kenya’s UHC framework.