6 Improve maternal health
Where we are?
Maternal Mortality in Kenya
Maternal mortality in Kenya has remained unacceptably high at 488 maternal deaths per 100,000 live births (with some regions reporting MMRs of 1,000/100,000 live births) in 2008/9, an increase from 414/100,000 in 2003, 590/100,000 in 1998. Most maternal deaths are due to causes directly related to pregnancy and childbirth unsafe abortion and obstetric complications such as severe bleeding, infection, hypertensive disorders, and obstructed labor. Others are due to causes such as malaria, diabetes, hepatitis, and anaemia, which are aggravated by pregnancy.
The proportion of women making the recommended number of antenatal care visits of 4 and above declined from 64 per cent in 1993 to 52 per cent in 2003 and to 47% in 2008/9, while the proportion receiving skilled care during delivery declined from 45 per cent in 1998 to 42 per cent in 2003. Skilled attendance at birth increased to 44% in 2008/9.
The contraceptive prevalence rate for modern methods among married women increased from 32% to 39% between 2003 and 2008/ while at the same time, the use of 64 traditional methods decreased from 8 to 6% of married women. The unmet need for family planning, which is still considered high, has remained at 24 percent since 1998. This has largely been attributed to inadequate service provision, poor access due to persistent family planning commodity insecurity and limited resource allocation.
Measures adopted in Kenya
The Government has prepared the Contraceptive Security Strategy 2007-2012 with the aim of ensuring uninterrupted and affordable supply of contraceptives. The adolescent birth rate reduced from 114 per 1,000 women to 103 per 1,000 women between 2003 and 2008/09.
The Government launched a Maternal and Newborn Health (MNH) Road Map in August 2010 whose goal is to accelerate the reduction of maternal and newborn morbidity and mortality towards the achievement of the Millennium Development Goals. The National MNH Road Map offers a new and revitalized dimension of efforts of all stakeholders. It provides a framework for building strategic partnerships for increased investment in maternal and newborn health at both institutional and programme levels. Implementation will take a phases approach and the final reporting year will be 2015.
To ensure all expectant mothers are safe and that they get quality health services, the government has abolished user fees in all public maternity hospitals and clinics. Mothers are being encouraged to deliver in the nearest maternity facility under the supervision of a skilled health worker. The government also committed to shifting budgetary resources from curative health to preventive health services (this shift was included in the 2010/2011 Budget). This will help deal with childbirth problems before they become serious. There are sustained efforts on decentralization of healthcare system to the districts to ensure local needs are better addressed
More rural women are receiving skilled assistance during delivery, reducing long-standing disparities between urban and rural areas. Serious disparities in coverage are also found between the wealthiest and the poorest households. In the developing regions as a whole, women in the richest households are three times as likely as women in the poorest households to receive professional care during childbirth
To reduce and bring down the high maternal mortality, the government has to address several challenges including the need to ensure the availability of adequate maternity services and skilled personnel to attend to complications caused by unsafe/induced abortion, malaria, and HIV/AIDS, among others.
The 8 Millennium Development Goals
- 1 Eradicate extreme hunger and poverty
- 2 Achieve universal primary education
- 3 Promote gender equality and empower women
- 4 Reduce child mortality
- 5 Improve maternal health
- 6 Combat HIV/AIDS, malaria and other diseases
- 7 Ensure environmental sustainability
- 8 Develop a global partnership for development
Targets for MDG 5
- Reduce by three quarters the maternal mortality ratio
- Most maternal deaths could be avoided
- Giving birth is especially risky in Southern Asia and sub-Saharan Africa, where most women deliver without skilled care
- The rural-urban gap in skilled care during childbirth has narrowed
- Achieve universal access to reproductive health & inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health
- More women are receiving antenatal care
- Inequalities in care during pregnancy are striking
- Only one in three rural women in developing regions receive the recommended care during pregnancy
- Progress has stalled in reducing the number of teenage pregnancies, putting more young mothers at risk
- Poverty and lack of education perpetuate high adolescent birth rates
- Progress in expanding the use of contraceptives by women has slowed & use of contraception is lowest among the poorest women and those with no education