Smart Cards Offer Medical Insurance in Kenya

A medical smart card system in Kenya is allowing mothers to save up towards the cost of childbirth at the country's largest maternal hospital.

The prepaid card enables women to top-up small amounts of money through the M-PESA mobile-phone based transfer facility, to then use when visiting the Pumwami Maternity Hospital in Nairobi. M-PESA, (M for mobile, pesa is Swahili for money) has become a huge hit in Kenya since its introduction in March 2007 and there are currently 2.3 million registered users. It provides a branchless banking service that is highly affordable and highly practical, especially in rural areas. Its use in the maternity smart card scheme has helped encourage women to take part: since early July, 500 cards have been purchased. The scheme is being set up by Changamka Microhealth, a Medical Insurance Provider that is wholly Kenyan and that uses innovative technology solutions to help provide services to developing nations.

In Kenya it is estimated that only 5% of the population have medical insurance. Whilst those working the formal sector pay obligatory health insurance, there remains 11 million adults and their dependants without cover. Raising the money to receive maternity care is a challenge for many Kenyans, resulting in the majority of women delivering without receiving professional care. According to the UN State of the World's Children 2009 report, in Kenya, only half of women receive continued antenatal care throughout their pregnancy. Only 60% of women give birth at home, and of those, 58% do not receive any skilled care. The consequences are serious: one in 39 women dies during childbirth, and for every 1000 births, 80 infants die before the age of one.

The costs of normal delivery are $42 at the hospital, and a caesarean costs $75. For those that receive emergency hospital care for childbirth, but without having the funds to pay for it, patients may be detained until the money has been raised. Having the ability to save up money using the medical smart card is the difference between life and death for many mothers and their babies. It also encourages a culture of saving up for healthcare, for childbirth and for other needs.

Schemes such as the medical smart card help progress towards achieving the Millennium Development Goal of improving maternal health. Goal 5 of the MDGs has two main targets: 1) to reduce by three quarters the maternal mortality ratio, and 2) to achieve universal access to reproductive health.