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Pulitzer Center Update July 18, 2011

Maternal Health in Kenya: What Evidence Shows and Ways Forward



The maternal mortality rate in Kenya is 530 maternal deaths per 100,000 live births, according to the World Health Organization.  The global average is about half that, at 260 deaths per 100,000 live births. Last week, maternal health experts in Washington and Nairobi convened, via webcam, to discuss some of the factors that endanger Kenya's mothers, and what can be done to change this.<br>
Participants identified problems in family planning, antenatal care, delivery, and postnatal care.  Nairobi experts explained that too many people do not have access to family planning services, leading to more unplanned and unwanted pregnancies.  Too few pregnant couples use antenatal care services and too small a percentage of deliveries take place in health facilities or with a skilled health worker. <br>
Catherine Kyobutungi, researcher at the African Population and Health Research Center, shared some statistics: among the poorest quintile of women in Kenya, approximately 70 percent deliver at home.  Barriers to access of health facilities include transportation costs and distance.  Even more alarming is that many women reported not seeing the need to deliver in facilities or with skilled health workers.<br>
One way to move forward, suggested Lawrence Ikamari, director of Population Studies Research Institute in Nairobi, would be to integrate service—for example, including HIV testing and counseling services in antenatal care visits.  He also pointed to the need for more training of midwives, exploring the possibility of strengthening health facilities' capacity to handle pregnancy complications, increased male involvement in antenatal care and maternal and newborn health, improved transportation and communication networks and a raise in government spending on health.<br>
Despite the problems, there have been some successes. Tony Daly, regional maternal health officer from the United Kingdoms Department for International Development, noted that maternal mortality rates have declined due to political will and efficient use of data.  He encouraged the global community to focus on strategies and data to keep political will strong. <br>
John Townsend, vice president and director of the Population Council Reproductive Health program, reminded the audience that Kenya's population, already at 40 million, is growing significantly.  Almost half of the current population is under 15.  This means, according to Townsend, that Kenya needs to refocus its education and advocacy programs to address a younger and growing population. <br>
Towards the end of the discussion, Ikamari called on a member of the Nairobi audience to speak.  Though unprepared, the woman spoke eloquently.<br>
She noted that Kenya loses almost 8,000 mothers a year.  After an oil tanker crash in Molo, Kenya killed over 200 people, the country went into mourning for five days.  But what of these 8,000 women, she asked, that die every year?<br>
"We've been looking at maternal health as a disease.  We need to look at the gender issues," she said.<br>
<em>The Pulitzer Center has supported significant coverage of maternal health world wide.  Visit the Gateway <a href="/dying-life">Dying for Life</a> to explore reporting projects on maternal health in Ethiopia, Mexico, Nigeria, India and Guinea-Bissau.</em>