A stark disparity exists in maternal health across Kenya's counties, with women in Nyeri County facing significantly lower risks of death during pregnancy and childbirth compared to those in Tana River and Samburu counties. According to the Kenya Demographic and Health Survey of 2022, Tana River County records 586 deaths per 100,000 live births, while Samburu County shares similar arid and semi-arid geographical challenges. In contrast, Nyeri County has a maternal mortality rate of 67 deaths per 100,000 live births.
In Tana River County, initiatives such as Soba Adhan's boda ambulance service are crucial in bridging the gap in maternal healthcare. Adhan's service provides transportation for expectant mothers and new mothers traveling to health facilities for antenatal care, delivery, or postnatal check-ups. This initiative, sustained for 10 years, was born from Adhan's personal experience of losing his mother to overbleeding after childbirth. He works with traditional birth attendants to help mothers reach skilled care in time, aiming to reduce maternal and neonatal deaths in the community.
Samburu County is also working to close the maternal health gap through communal efforts. In Nongoiro Village, midwives from Samburu Teaching and Referral Hospital travel 40 kilometers to bring care closer to women. A shaded tree serves as a makeshift health facility, providing care to women who need it most. This midwifery model takes maternal care from hospital to home, reaching women in some of Samburu's hardest-to-reach areas. The county's maternity shelter at the Samburu Teaching and Referral Hospital provides a safer place for women with high-risk pregnancies to await delivery.
The Samburu County CEC for Health reports that between January and February, 55 mothers were accommodated in the maternal shelter, and all delivered safely. The county has also invested in a newborn unit at the Samburu County Referral Hospital. According to the CEC, maternal mortality figures in Samburu have decreased from 1,000 per 100,000 live births in 2013 to around 275.
Nyeri County's success in reducing maternal mortality can be attributed to its extensive network of health facilities, with 430 facilities, including 134 county government facilities, one Level 6 facility, and 296 faith-based or private facilities. The average distance from one facility to another is three kilometers, apart from Kieni Sub-County, where the distance increases to five kilometers. Nyeri is one of only 12 counties in Kenya that meets the World Health Organization's recommended core health worker threshold.
The road access in most parts of Nyeri County is also strong, helping residents reach health facilities. This model, if replicated and adapted across the country, could fundamentally change the story for mothers and their newborns. However, for mothers in Tana River and Samburu, lasting change will require more than local interventions, including better roads, financial protection, and stronger referral systems.
To achieve its 2028 commitment to end preventable maternal and newborn deaths, Kenya must draw lessons from counties like Nyeri, Tana River, and Samburu. The country needs to prioritize access to healthcare, strengthen referral systems, and provide financial protection to ensure that all women have access to quality maternal care, regardless of their geographical location.
Key points
- A woman giving birth in Nyeri County is nearly nine times less likely to die from pregnancy and childbirth complications than a woman in Tana River.
- Nyeri County's extensive network of health facilities and strong road access contribute to its low maternal mortality rate.
- Counties like Tana River and Samburu require more than local interventions to achieve lasting change in maternal healthcare.
