Accelerating the Gains of the Free Maternity Care in Kenya\u27s Urban Informal Settlements

The 2010 Constitution of Kenya recognizes the special group of women living in urban informal settlements, and provides for their access to the highest attainable standards of health care, including reproductive health care. The Health Act, which was enacted in 2017, recognizes the significant challenges of accessing maternal health services among the poorest populations. Pursuant to the resolutions of the African Union, the Health Act abolished user fees for pregnant women. The Health Act instructs the county and national governments to expand free maternity care and childhood immunizations through funding. Despite Kenya’s commitment to increase the national budget for health care to 15% of the gross domestic product (GDP), the budgetary allocation for free maternity services has not increased over the years. Therefore, for the Health Act provision requiring free maternity care to be meaningful for women living in urban informal settlements, and improve their birth outcomes, the county and national governments must increase funding for basic medical facilities, essential health supplies and staffing needs in these areas. There are currently no adequate legal and policy frameworks for increasing maternal health care funding and accelerating the impact of the free maternity services program on maternal health outcomes in Kenya’s urban informal settlements. In this Article, I propose that the national and county governments must increase funding for basic medical facilities, supplies and staffing at the county level to improve maternal health outcomes for the women living in urban informal settlements. The first part of this Article will describe the current state of the urban informal settlements. The second part will examine the state of maternal health care in Kenya’s urban informal settlements. The third part will explore the governance structure for implementing the right to maternal health care in Kenya. The fourth part will explore the existing legal frameworks that promote the right to maternal health care in Kenya. The fifth part will provide recommendations for improving maternal health care in Kenya’s urban informal settlements