Health facilities and medical practitioners with high maternal mortality rates will no longer have their licences renewed, Health Cabinet Secretary Aden Duale has announced.
The measure comes as Kenya grapples with alarming statistics. Last year, the country was ranked fourth in the 2024 report on Preventing Child and Maternal Deaths by the United States Agency for International Development (USAid), among the top five African countries where expectant mothers die from childbirth complications, with 594 deaths per 100,000 live births.
Between 2020 and last year, 7,764 Kenyan women died while giving birth, according to Unicef. The lifetime risk of maternal death in one year stands at 52 per cent.
Speaking in Nairobi during the launch of the Kenya Quality of Care Health Facility Assessment Reports and the Reproductive, Maternal, New-born, Child and Adolescent Health and Nutrition Investment Case (RMNCAH+N) on Tuesday, CS Duale revealed shocking findings.
"When expectant mothers are dying on your watch, your medical licences are of no importance to us," he said. "The findings show that only four out of 10 health facilities in the country have the capacity where expectant mothers can effectively deliver."
The Ministry found many medics in public and private health facilities were managing patients via mobile phones instead of being physically present.
Duale announced the Ministry of Health will soon launch a nationwide survey targeting all health facilities to save mothers who die from gross medical negligence and malpractice.
"Some doctors who have been using the Practice 360 App from their bedrooms to discharge patients can no longer do so. They must now be within 500 metres of the health facility for the app's OTP to work," he said. "The app is geo-fenced to health facilities and allows healthcare workers to manage pre-authorisation claims directly."
The CS announced the Digital Health Authority (DHA) is developing a dashboard for real-time monitoring of all deliveries in health facilities.
"We will allow county health officials access so that together we ensure expectant mothers who walk to health facilities in perfect and good health do not lose their lives due to medical negligence," he said.
Medical Services Principal Secretary Ouma Oluga said they will be more vigilant about health worker competency and performance.
"We will not renew licences of health facilities whose mortality rates are high. Competency and performance must go hand in hand," Dr Oluga said. "You can't be a surgeon who doesn't take clinical notes. We have observed this in older and more senior doctors who do not follow laid-down procedures and guidelines when treating patients, compared to younger doctors."
Dr Edward Serem, head of the Division of Reproductive and Maternal Health at the Ministry of Health, said most expectant mothers die from postpartum haemorrhage (PPH).
Tana River, Garissa, West Pokot, Elgeyo Marakwet, Machakos, Homa Bay, Siaya, Wajir, Kilifi, Murang'a, Makueni, Migori and Turkana counties record the highest deaths.
Despite progress, the maternal mortality ratio stands at 355 per 100,000 live births, while the neonatal mortality rate is 21 per 1,000 live births.
Data from 2017 to 2024 showed 98 per cent of expectant Kenyan women managed at least one antenatal clinic visit, while 66 per cent managed four visits. Eighty-nine per cent were attended to by a skilled birth attendant, 61 per cent delivered in a healthcare facility, and nine per cent underwent a caesarean section.
In the same period, 83 per cent of new-borns received a postnatal health check alongside 78 per cent of new mothers.
In March last year, Dr Janet Karimi, head of New-born and Child Health, told Nation that 24 health facilities across 13 counties contribute significantly to the high rates of maternal and neonatal deaths.
The RMNCAH-N (Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition) Investment Case identifies several challenges, according to Dr Serem.
"Some healthcare providers lack the necessary knowledge and skills to deliver quality RMNCAH-N services. Referral systems between health facilities are inefficient, while few facilities offer emergency services for women, new-borns and children, including essential equipment and drugs," he told delegates.
Other challenges include delays in emergency care leading to neonatal asphyxia, which contributes significantly to new-born mortality and infant/child morbidity. Uptake of RMNCAH-N services is low due to inadequate demand creation initiatives, and many women of reproductive age lack access to high-quality family planning services.
Dr Serem said nutritional services for women, new-borns, children and adolescents remain limited. There is inadequate human resource for health and uneven distribution of skilled health workers, with some areas experiencing shortages while others have a surplus.
"Government funding for RMNCAH-N services is low at both national and county levels, with no dedicated funding. There is over-reliance on donor funding for RMNCAH-N health products and technologies, as well as frequent stock-outs of RMNCAH-N commodities," he said.
Kenya is also grappling with limited capacity in supply chain management for maternal, new-born and child health commodities.
Dr Serem said addressing these challenges requires substantial investment.
"Addressing these challenges is crucial for improving health outcomes for women, new-borns, children and adolescents and to end preventable stillbirth," he said. "The RMNCAH-N Investment Case 2025/26-2029/30 addresses these challenges through increased funding, with the ultimate objective of enhancing quality of life for women, new-borns, children and adolescents."
Grow annually
The total estimated investment will grow annually, starting at Sh79.59 billion (US$612 million) in 2025/26 and reaching Sh105.79 billion (US$814 million) by 2029/30. Over five years, the cumulative investment required is Sh460 billion (US$3.54 billion), with contributions expected from national and county governments, Social Health Insurance, the private sector and development partners.
According to the Ministry of Health, Maternal and New-born Health accounts for over 40 per cent of the total investment annually. This is followed by immunisation (18 per cent), child health (over 12 per cent), gender-based violence/gender equality (8 per cent) and family planning (6.7 per cent). Over 31 per cent annually will go towards human resources for health.
However, financial projections reveal a significant funding gap. Estimated available resources are Sh49.92 billion (US$384 million) in 2025/26, rising to Sh53.57 billion (US$412 million) in 2026/27, Sh53.78 billion (US$414 million) in 2027/28, Sh56.32 billion (US$433 million) in 2028/29 and Sh52.47 billion (US$404 million) in 2029/30.
"The funding gap is expected to increase from approximately Sh29.67 billion ($228 million) in 2025/26 to Sh53.32 billion (US$410 million) in 2029/30," Dr Serem said.
Dr Patrick Amoth, Director General for Health at the Ministry of Health, said this investment could save an estimated 27,995 child lives, 4,611 maternal lives and prevent 11,071 stillbirths over five years.
"These lives saved translate into significant productivity gains: healthy adults contribute immediately, while children promise future economic productivity," he said.
Dr Serem said the estimated Sh565 billion boost to GDP underscores this potential.
"With a return on investment of Sh12.50 for every shilling spent, the benefits are not only financial but deeply human—each life saved represents hope, potential and a brighter future for families, communities and the nation," he said.
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