By Nuru Salim
More than 20 pregnant women have died in Kwale County this year, according to figures from the County Health Department. The grim tally has sent shockwaves through health circles and raised serious questions about access to timely and adequate maternal care in the Kwale.
The spike comes as Fanikisha Foundation, a reproductive health-focused organization, sounded the alarm this week, warning that if the trend continues unchecked, the 2024/2025 period could end up worse than the already troubling numbers of 2023/2024.
“According to statistics we have a challenge of mothers attending the antenatal clinics. Ideally, mothers are expected to start their ANC at least before 12 weeks. This will give time and space for the nurses to do fundamental tests, engage with the mother in giving her safety measures and other services that will help the pregnant mother to take care of her pregnancy,” said Christine Mvurya, the founder and director of Fanikisha Foundation.
The county’s maternal death ratio has now reached 110 per 100,000 live births — above the World Health Organization’s threshold of 100, which signals a health emergency. This is an alarming rise from the previous year, which saw 23 maternal deaths out of 24,925 live births, equating to a ratio of 92 per 100,000.
While a range of factors are to blame, one stands out: poor antenatal clinic attendance. This year, only 76% of the 22,049 expected mothers attended ANC services, down from 79% the previous year when 30,735 women were expected to seek prenatal care.
The data also reveals troubling disparities at the ward level. Mkongani and Tiwi wards have the lowest ANC coverage, with just 61% and 59% of expectant mothers attending, respectively. In contrast, Mwereni Ward recorded a 100% attendance rate which is a rare outlier in a county struggling to protect maternal health consistently.
“There are crucial health services that these pregnant mothers miss due to not attending the antenatal clinics earlier,” Mvurya noted. “Reproductive health is not based on experience, and every pregnancy can come with its own challenges, so it’s very important to visit health facilities in order to receive the necessary care.”
Compounding the crisis is the cultural stigma that still surrounds certain medical interventions. Some communities in Kwale view cesarean deliveries as a sign of weakness, discouraging women from seeking potentially life-saving surgical interventions.
At the national level, Kenya’s maternal mortality rate remains high at 355 deaths per 100,000 live births, according to the 2019 census. The country is significantly off-track in meeting the Sustainable Development Goal (SDG) of reducing that figure to 70 per 100,000 by 2030. Similarly, the neonatal mortality rate remains at 21 per 1,000 live births, well above the SDG target of 12.
To address the crisis, Fanikisha Foundation spearheads the Okoa Mama na Mtoto Initiative(OMMI), partnering with the Kwale County health department and media to intensify community outreach and maternal health education. The project is specifically targeting rural communities, where health literacy and service uptake remain low.
“Most people face challenges like inability to access health facilities due to financial constraints, but it’s crucial to visit the clinics for the mother’s safety and the unborn,” Mvurya emphasized.
Reproductive health advisor Edward Mumbo echoed the Foundation’s urgency: “Maternal deaths are a serious challenge facing our community. It should never be normal for a mother or her baby to lose their life during childbirth, it is only right that every mother delivers safely.”
He called on women to make full use of available healthcare services, saying that timely access can drastically reduce the risks associated with childbirth.
Fanikisha Foundation recommends that at least 90% of pregnant women attend a minimum of eight ANC visits, with 90% of births being attended by skilled health professionals. Additionally, 80% of mothers and newborns should receive early postnatal and essential newborn care for optimal health outcomes.
