NAIROBI, Kenya — Proponents of Kenya’s recently enacted free maternal health care services are citing a Nyamira County hospital’s recent statistics. According to the hospital’s administration the number of births it attended increased by 12.5 percent between May and June of this year. The hospital reported this puts them at 76 percent of births attended by a professional health care provider. This is an increase from 58 percent last year.
Before the fees were waived, Kenyan mothers would have to pay from 12 to 90 dollars for public health care depending on the provider. This does not include the costs for cesareans which could run over a hundred dollars.
The statistics from Nyamira County are welcome news for the programs supporters. Some hospitals have reported a drop in the number of attended births. Hospital staff believe this is caused by a number of women assuming the fee waiver indicates a lower level of service. Other women still prefer a traditional midwife to professional staff. In Kenya, only approximately 46 percent of expectant mothers deliver in a hospital. This is due to a combination of factors: preference for traditional midwives, lack of access to professional facilities, lack of ability to pay for fees, and hospital inadequacies.
In 2010 Kenya had a staggering 360 deaths per 100,000 live births, according to World Bank data. While this had decreased from 460 per 100,000 live births in 2005, the Kenyan Ministry of Medical Services reports much higher figures.
The issue of maternal mortality is especially concerning in Kenya’s Northeastern region. It is estimated that only five percent of the population in this area have access to maternal health care facilities. The maternal mortality rates for this area are significantly higher than the rest of the country. The nearest facilities are often too far, the journey made longer and more treacherous by poor roads.
There have been several criticisms made since the fee waiver’s enactment on June 1 this year. One involves the shortage of medical professionals. Even without increased attendance, hospitals are short staffed and lack the professional health care providers that these women seek.
Another fear was the lack of funding to provide for increased attendance. However, hospitals are reporting that the government provides extra public funding each week to help handle increased births. There are still some shortages, though, mainly related to space and facilities.
There are other aspects to Kenya’s maternal mortality rates, however. Among these are unsafe abortions which account for 35 percent of maternal deaths in the country. Many maternal deaths occur among teenagers who hide the pregnancy until too late or have increased complications. Female genital mutilation often requires professional assistance, given damage to the birth canal. However, many of these women do not have access to public facilities or go to them too late in the delivery.
The fee waiver for maternal health care was enacted by Kenya’s new president, Uhuru Kenyatta, as an implementation of a key campaign pledge. Kenya faces a monumental change in meeting the Millennium Development Goal to reduce maternal mortality by 75 percent by 2015.
– Callie D. Coleman