Kenya has made slow progress in reducing maternal deaths. Despite ongoing efforts by the national government and global initiatives, there were an estimated 362 deaths per 100,000 live births in 2014. One explanation for the persistently high maternal mortality rate is that many pregnant women cannot access maternity services before, during or after birth. Cost remains a major barrier to care for many households.

In order to increase access to and use of maternal health services, in June 2013, the President of Kenya announced a policy offering free care for all women giving birth in a public health facility. The policy received widespread support from both clients and healthcare providers; however, its hurried implementation has had some adverse effects on health facilities.

This policy brief highlights both the positive and negative effects of the Free Maternity Services Policy based on research conducted in health facilities in three counties in Kenya. It outlines the challenges to implementing the policy and suggests how the Ministry of Health can make improvements going forward.