Linda Mama was more than just a health program; it was a lifeline. It represented the state at its best: deliberate, targeted, and compassionate in its focus on one of society’s most vulnerable groups. At its core, Linda Mama sought to protect poor, indigent, and at-risk women who could not pay NHIF premiums but who still deserved the most basic of dignities, safe pregnancy and delivery care. For thousands of Kenyan mothers, Linda Mama was the difference between life and death, between dignity and despair.
This is why Linda Mama mattered. It was not a sweeping, abstract promise. It was concrete. It was precise. It was about real women, real babies, and real lives. It was designed to reach those who otherwise would have been left behind. And in doing so, it gave Kenya something we could be proud of: a maternal health program that truly understood the urgency of vulnerability.
Fast forward to today, and we are faced with questions that demand honest answers. Do we still have poor, needy, and abused women in Kenya seeking reproductive care? Are there still expectant mothers in our villages, informal settlements, and rural areas who cannot afford SHA premiums? Anyone living in this country knows the answer without hesitation: YES. The need has not disappeared. Poverty, inequality, and structural barriers to care remain part of the daily reality for millions of women. So then, how exactly is the Social Health Authority (SHA) protecting them? The brutal truth is this: it isn’t. At least, not yet.
The irony in all this is that the law already provides a clear pathway. Section 25 of the Social Health Insurance Act explicitly mandates Parliament to allocate funds for indigent and vulnerable persons. Regulation 19 of the SHA Regulations further places responsibility on both the National and County governments to contribute toward this cover. The blueprint is written in black and white. The legal framework exists. Yet what we are witnessing is leadership paralysis, a refusal to translate law into action. Instead of concrete measures, we get hollow frameworks and dead letters of the law.
Recently, the Head of State stood before cameras and triumphantly announced the SHA cover for 2.2 million indigent households. On the surface, this sounded impressive. It was delivered with the kind of political flair designed to inspire hope. But look deeper, and the cracks become evident. That blanket cover is not targeted at indigent expectant women, the very group most in need of focused intervention. Instead, what we have is a numbers game, a political statistic meant to tick boxes, not a maternal health strategy meant to save lives.
As a research practitioner, I know this much: a “household” statistic does not automatically translate into a mother in need. Households are a broad and general category. Maternal health requires precision targeting. Linda Mama succeeded because it was deliberate about women, pregnancy, and birth. It was designed with mothers in mind. That precision is what SHA has lost, and without it, the program risks becoming an expensive bureaucracy that looks good on paper but fails in practice.
The issue has never been the existence of a need. The need is glaring, almost blinding in its urgency. Every maternal death, every preventable complication, every woman turned away because she cannot afford the costs is a reminder of how much we are failing. The issue has always been leadership, or rather, the lack of it. Leadership goodwill and efficiency in health financing are the missing pieces. Without them, Universal Health Coverage (UHC) will remain just that, a hollow slogan, recycled in speeches, printed on banners, and forgotten once the cameras turn off.
It does not have to be this way. Kenya has already signed onto bold continental commitments that map a way forward. The Abuja Declaration of 2001 called on African governments to allocate at least 15% of their annual budgets to health. The Addis-Ababa Declaration of 2006 reinforced the centrality of sustainable health financing. The Ouagadougou Declaration of 2008 further affirmed the urgency of building resilient health systems across Africa. Kenya is a party to these treaties. We signed them. We stood on global stages and promised to make them real. Yet, decades later, we are still treating these declarations as historical curiosities instead of binding calls to action.
The time for excuses has long passed. Women continue to die from preventable complications of pregnancy and childbirth. Families are being pushed deeper into poverty by catastrophic out-of-pocket health expenditures. Communities are losing mothers, sisters, daughters, and wives, all because leadership has refused to prioritize maternal health in a meaningful way.
If SHA is to succeed where Linda Mama left off, it must embrace the principle of precision and the ethic of protection. It must return to the vulnerable woman at the heart of the matter. Anything less will reduce it to another hollow promise, another failed slogan in the long list of abandoned reforms.
My rallying call is clear: let us hold our leaders accountable to their word, their laws, and their treaties. Let us demand not just frameworks but financing. Not just declarations but delivery. Until then, Universal Health Coverage will remain an aspiration rather than a reality. The mothers of Kenya deserve better. They deserve action now.
Bill Clinton Oulo
Bill Clinton Oulo is a Health Economist and Policy Professional with over five years of experience in public health research, sexual and reproductive health, and wellbeing economics.
He is a former President of the University of Eldoret Students Organization(UoESO), a Leadership and Governance Mentor, a Youth Leader.
Bill has played a part in the Political space of the Country with the recent one being National Lobby groups Coordinator for Azimio la Umoja Campaigns, 2022.
