What you need to know:
- Maternal mortality cases are prevalent in informal settlements.
- The cases are also high in societies that still practice traditional childbirth methods.
Kenya joined other African states in waiving delivery fees in all public health facilities on June 1, 2013. At a maternal mortality ratio that stands at 362/100,000 and 35,000 stillbirths annually, there is a need to question why this uncomfortable statistic prevails, eight years down the line.
Despite the fee waiver, only 61.2 per cent of expectant mothers deliver in health facilities. The high number of mortality and infancy deaths shows that apart from cost, there are other underlying factors. Inferior quality of services in our health facilities and other social economic and cultural factors could be at play.
Maternal mortality cases are prevalent in informal settlements. The cases are also high in societies that still practice traditional childbirth methods. This also comes with other maternal health related challenges ranging from the high burden of HIV/Aids, antenatal care, and family planning.
Although 90 per cent of women in rural areas seek antenatal care, according to the United Nations Population Fund (UNFPA), many wait until the second and third trimester, which reduces the efficacy of vaccines.
The level of awareness on the importance of maternal care is still low at the local level. The complex nature of the health sector, which has faced many challenges since it was devolved, including the provision of its core mandate, has affected delivery of other supportive infrastructure such as public sensitisation on health-related issues that would reduce cost.
For instance, early assessment can determine if the pregnancy is a high-risk one or not. Many women do not see the need to seek maternal health care, despite its importance, as long as they are feeling okay. Owing to its huge budgetary allocation, the health ministry should help in collecting empirical data on maternal health status to identify policy gaps.
However, inadequate resources have been an obvious gap. For instance, although the World Health Organization recommends at least 23 doctors, nurses and midwives per 10,000 people, Kenya had one doctor, 12 nurses and midwives per 10,000 people in 2017.
Findings also reveal that most government hospitals were built during the colonial period or in the late 1970s and cannot effectively serve the current population. In some communities, the role of the midwife has increased because of inaccessible health facilities.
Mr Obonyo is a policy analyst. firstname.lastname@example.org