Makueni hailed for maternal health innovation

Makueni County has been lauded for its strides in maternal and child health, recording zero maternal deaths from post-partum haemorrhage (PPH).

The achievement is attributed to innovative healthcare practices, including the adoption of heat-stable carbetocin, recommended by the World Health Organisation (WHO), to prevent excessive bleeding after childbirth.

The county has also embraced calibrated drapes, a specialised tool used to measure blood loss during delivery, ensuring accurate monitoring and allowing medical personnel to respond swiftly to abnormal bleeding.

Makueni stood out during the kickoff of the International Maternal Newborn Health Conference in Nairobi, which has brought together experts from across the globe to explore solutions to the rising deaths of mothers and newborns during childbirth.

Makueni Governor Mutula Kilonzo attributed the achievement to getting solutions to issues that triggered maternal and child deaths.

Speaking during the update on Kenya’s journey to ending preventable maternal and newborn deaths, Kilonzo regretted that mothers and babies are dying because of reasons best known to policymakers and leadership.

Kenya’s maternal mortality ratio stands at 355 deaths per 100,000 live births, translating to an estimated 5,000 women and girls dying annually due to pregnancy and childbirth-related complications, according to the 2019 census report.

Causes of maternal mortality in Kenya include PPH, eclampsia, sepsis, antepartum haemorrhage, unanticipated complications of pregnancy, abortion, ruptured uterus, obstructed labour, and ectopic pregnancy.

“PPH remains one of the leading causes of maternal deaths globally because society and systems have failed to prioritise women's lives. It is not primarily clinical failure, but a political one. We need to prioritise maternal and child health,” said Kilonzo.

He added, “PPH is predictable, it's diagnosed and treatable.”

Nevertheless, at least 4 babies die every single hour in Kenya, representing 92 in a day.

Causes of neonatal death according to the Kenya Health Information System (KHIS) data include prematurity (34 per cent), asphyxia (32 per cent), and sepsis at eight per cent.

Neonatal mortality rate stands at 21 per 1,000 live births, translating to 30,000 newborn deaths per year. Neonatal deaths contribute to 52 per cent of under-five mortality. 

According to the ministry, there is a need to reduce neonatal mortality rates by 45 per cent, reaching the Sustainable Development Goals (SDG) goals of less than 12 per 1,000.

“These numbers represent women who die bringing lives into this world and families traumatised by the loss. If such mortalities affected men, a global response could be immediate.

Policy makers respond to data scale, yet maternal deaths remain invisible within political decision-making. Leaders must sit in these meetings and listen to what is causing problems,” said Kilonzo.

One of the challenges in managing PPH, according to the governor, who is the PPH champion, is the delay in accessing healthcare.

“There is a need for the embedding of maternal essentials; medicines should be available in the furthest points where women should give birth unhindered.”

Kilonzo further asked for the involvement of key individuals, including men, to end maternal and child death.

"I lead a team that is dedicated to serving," said Kilonzo.

He added, “I am a father and husband, and I have signed and been to the theatre. This explains that men in the room need to participate to understand. When I speak about this, I speak from personal experience. I bother to walk in clinics and dispensaries to check”.

Makueni, a county that was once listed among the top ten highest in maternal and child deaths, has been working with respective partners to supply drugs, train healthcare providers and equip hospitals, and has established the Family Unit to handle health holistically.

Director General of Health Dr Patrick Amoth said: “Women are dying because society has yet to decide their lives are not worthy of dying”.

“We have tools, yet mothers and children continue to die. This forms the basis of this conference. Let us remember statistics represent lives, families' dreams and future interrupted and lost,” said Amoth.

The official noted that at least 26 counties are leading in maternal and child health, where more focus should be put.

"At least 26 out of 47 counties contribute to all maternal mortalities. Our focus should be on these 26 counties," Amoth said. 

According to a facility study of 2025 conducted by the Ministry of Health, at least 1,107 deaths were documented, with PPH having been the leading cause of maternal deaths. 

Maternal and newborn indicators according to the Kenya Demographic Indicators Survey (KDHS) 2022, births in health facilities stand at 82 per cent, skilled birth attendance during childbirth at 89 per cent, and at least 66 per cent of pregnant women attend for one or more ANC visits, with 98 per cent of women attending at least the first ANC visit.

Despite efforts in legal and policy, expanded essential service coverage, infrastructure, and enhanced accountability mechanisms, maternal and neonatal mortality rates remain above global targets, demanding accelerated and coordinated plans that call for partnerships, collaboration and the use of data for evidence decision making.

To help avert the deaths, Amoth noted that Kenya is entering a defining phase with the launch of the national Reproductive Maternal Newborn Child Adolescent Health Investment case 2025-2029, which focus on equity, quality and accountability aligned with the global "Moving Forward Together" agenda guided by the National Every Woman Every Newborn Everywhere (EWENE) acceleration plan for 2026-2028.

The initiative, he said, aims to accelerate the reduction of maternal and newborn deaths.

Despite the 2024 quality of care assessment highlighting that only 37 per cent of facilities meet the full basic emergency obstetric and newborn care criteria.

To scale quality maternal and newborn health services for UHC, the government of Kenya is supporting counties to equip high-volume facilities to provide emergency obstetric and newborn care through partnerships.

Central to this progress is the alignment with the 10 pillars of the EWENE framework, which integrates sustainable financing, skilled workforce expansion, and specialised newborn care.

An estimated US $ 138 million (Sh18 billion) investment is required to scale up newborn care in Kenya in line with government norms and standards across 47 counties and 80 per cent of sub-county facilities.

ON her part, Council of Governors (CoG) Chief Executive Officer (CEO) Mary Mwiti said since the advent of devolution, counties have remained at the forefront of health service delivery, providing over 70 per cent of healthcare services nationwide.

Mwiti said counties, at the forefront of Health Service delivery, have made deliberate investments in strengthening primary healthcare, expanding access to skilled birth attendance now at approximately 89 percent Nationally and improving antenatal care coverage, with over 90 per cent of women attending at least one ANC visit.

“Facilities across Counties have been upgraded to provide Basic and Comprehensive Emergency Obstetric and Newborn Care, supported by improved referral systems, ambulance services, maternity infrastructure and strengthened Maternal and Perinatal Death Surveillance and Response (MPDSR) mechanisms,” said Mwiti.

The CoG boss added that the council has placed the well-being of mothers and newborns at the centre of inter-county collaboration, accountability and action.

“The Council is actively supporting Counties to strengthen Maternal and Perinatal Death Surveillance and Response (MPDSR) systems through coordinated initiatives that promote timely reporting, multidisciplinary reviews and implementation of corrective measures,” said the official.

This, she said, is being done by mapping and analysis of maternal and perinatal indicators across counties, enabling identification of high-burden areas, service gaps and underlying determinants of poor outcomes.

The data-driven insights are guiding counties on where to prioritise investments, deploy skilled personnel, strengthen referral pathways and improve quality of care.

Principal Secretary (PS) State Department of Public Health, Mary Muthoni, on her part, asked for stakeholders' engagement in boosting maternal and child care.

Further, Amoth drummed up support for domestic health financing in a move to end maternal and child deaths.