IDEAS home Printed from https://ideas.repec.org/a/plo/pgph00/0002796.html
   My bibliography  Save this article

Policy formulation and actor roles in the expanded Kenyan free maternity policy (Linda Mama): A policy analysis

Author

Listed:
  • Boniface Oyugi
  • Zilper Audi-Poquillon
  • Sally Kendall
  • Stephen Peckham
  • Edwine Barasa

Abstract

In 2013, Kenya implemented free maternity services, later expanded in 2016 into the ‘Linda Mama’ policy to provide essential health services for pregnant women. This study explored the policy formulation background, processes, content, and actors’ roles in formulation and implementation. Using a convergent parallel mixed-methods case study design, we reviewed documents and conducted in-depth interviews with national stakeholders, county officials, and healthcare workers. We applied a theoretical framework capturing the background and context, processes, content, and actors. The study spanned national, county, and facility levels within Kenya’s health system. Data were audio-recorded, transcribed, and analyzed using a framework thematic approach. Findings showed that political imperatives and global and national goals shaped the expanded policy, drawing on previous learnings. Actor power played a crucial role in shaping policy direction, reflecting their interests and capacity to influence decisions. The policy aimed to improve coverage and administrative efficiency, with NHIF becoming the primary purchaser of services to ensure sustainability and address legal challenges. The policy design, marked by conflicts and time pressures, required a collaborative approach to reconcile design and costing differences. Despite differing interests, discussions and dialogues were essential for leadership and conflict management, culminating in key policy documents. A committee was established for stakeholders to freely discuss and debate the policy design, enabling relevant players to devise solutions and fostering joint commitment for implementation. Government officials, development partners, and representatives significantly influenced policy formulation. Beneficiary representatives had limited awareness of public participation opportunities. National and county actors supported achieving audit, research, financing, and strategic operational goals crucial for policy implementation. In conclusion, this study highlights the continued significance of policy analysis frameworks and theories in understanding the complex nature of policy development. These findings offer valuable insights for countries designing or redesigning healthcare policies and provide relevant information to academic communities.

Suggested Citation

  • Boniface Oyugi & Zilper Audi-Poquillon & Sally Kendall & Stephen Peckham & Edwine Barasa, 2024. "Policy formulation and actor roles in the expanded Kenyan free maternity policy (Linda Mama): A policy analysis," PLOS Global Public Health, Public Library of Science, vol. 4(11), pages 1-33, November.
  • Handle: RePEc:plo:pgph00:0002796
    DOI: 10.1371/journal.pgph.0002796
    as

    Download full text from publisher

    File URL: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0002796
    Download Restriction: no

    File URL: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0002796&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pgph.0002796?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pgph00:0002796. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: globalpubhealth (email available below). General contact details of provider: https://journals.plos.org/globalpublichealth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.