1. Maternal Mortality Situation in KenyaBy
Prof Alfred Agwanda
Population Studies and Research Institute
University of Nairobi , Kenya
Presentation Made at the
CONSULTATIVE MEETING ON ACCELERATING THE ATTAINMENT OF MDG 5 IN KENYA: FOCUS ON THE 15 COUNTIES WITH THE HIGHEST BURDEN OF MATERNAL DEATHS
August 27-August 28, 2014
The Boma Hotel, Nairobi

2. Introduction
Reducing maternal deaths have for decades been a focal point of international agreements and a priority for women’s rights and health groups throughout the world
In Kenya, Slightly over 6000 women die every year due to pregnancy related conditions
The irony of this cruel death is that almost all is entirely preventable given proper medical surveillance and intervention

3. Trends in maternal mortality and Programme Targets

4. Top 15 Counties with highest Number of Maternal Deaths

5. Top 10 counties Highest Maternal Mortality Ratio

7. Reasons why women don't deliver in facilities
Ignorance – e.g. facilities still charge high fees
Fear of being tested for HIV, fear of bed used – child might fall down
Poor quality of care
Social-Cultural factors: Customs/tradition – some women do not want to been seen by male providers, sign of strength, placenta must be buried at home
Facility factors – distance to facility, cost of transport, operating hours, relationship with providers ( cite poor attitude e.g. harassment such as the following
You know the nurses are harsh so we go to a TBA who treats us well ( Source, KSPA 2010)

8. Challenges Coverage emergency obstetric care services still low
Approximate number of deliveries in Kenya is 1.7 million deliveries
Out of these deliveries nearly three 300,000 are likely to require emergency obstetric services
Only 35 percent of facilities offer maternity services while
Only 34 percent can provide newborn care services
Access still hampered by structural factors
Road network – geography
Some facilities lack electricity, running water
Lack Essential commodities
Staff training, work load

9. Recommendations Governments and partners should :
Scale up and support registration of births, deaths and causes of death.
Infrastructure support and public education
Support the operationalization maternal and perinatal death surveillance (MPDSR)
Leaders need data to support decision making – all facility and county officers responsible for routine data collection should ensure quality data to provide evidence on results for interventions
Commission studies to investigate indirect factors that influence maternal deaths especially in counties with high burden.
Improve the availability, accessibility, quality and use of services for the treatment of complications that arise during pregnancy and childbirth.

10. Message
To effectively set up intervention on reduction of maternal and newborn deaths generate data and information at all levels about cause on maternal deaths”
Act now