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MATERNAL MORTALITY IN KENYA: THE STATE OF HEALTH FACILITIES IN A RURAL DISTRICT
Abstract
Background: This study was formulated from the premise that the known causes of maternal
mortality, namely haemorrhage, sepsis, obstructed labour and abortion belie the more
fundamental development problems that influence it, such as the state of local medical
services, quality ofcare and the facilities' ability to respond to reproductive health emergencies.
Objective: To document some of the underlying problems and how they were found to
influence maternal mortality in Kenya, with specifi reference to a rural district.
Design: The researchers used the Prevention of Maternal Mortality Network (PMMN)
methodologylstudy design to assess the current state of health facilities, their level of
function, and factors influencing their utilisation. Both qualitative and quantitative methods
of data collection tools were used.
Setting: Siaya District in the western region of Kenya. Data were collected from thirty
facilities, which provide obstetric care in the district.
Participants: Data were collected by nurselmidwives, nursing school tutors and social
scientists with experience in qualitative research methods. Respondents included health
service providers and managers at the 30 health facilities. Qualitative data were obtained
through focus group discussions with health facility staff as well as community members.
Results: All the thirty facilities studied, were grossly wanting in terms of staffing, equipment,
essential drugs and supplies. Both quality of care and record keeping were well below
acceptable standards.
Conclusions: The study findings are a sad but a fair reflection of our situation not only in
Kenya but also in sub8aharan Africa ten years after the declaration of the Safe Motherhood
Initiative (SMI). The results indicate a predictable, widening gap in basic service provision
that must be urgently bridged as a prerequisite to any serious and meaningful approaches
to reducing maternal mortality in Africa.
mortality, namely haemorrhage, sepsis, obstructed labour and abortion belie the more
fundamental development problems that influence it, such as the state of local medical
services, quality ofcare and the facilities' ability to respond to reproductive health emergencies.
Objective: To document some of the underlying problems and how they were found to
influence maternal mortality in Kenya, with specifi reference to a rural district.
Design: The researchers used the Prevention of Maternal Mortality Network (PMMN)
methodologylstudy design to assess the current state of health facilities, their level of
function, and factors influencing their utilisation. Both qualitative and quantitative methods
of data collection tools were used.
Setting: Siaya District in the western region of Kenya. Data were collected from thirty
facilities, which provide obstetric care in the district.
Participants: Data were collected by nurselmidwives, nursing school tutors and social
scientists with experience in qualitative research methods. Respondents included health
service providers and managers at the 30 health facilities. Qualitative data were obtained
through focus group discussions with health facility staff as well as community members.
Results: All the thirty facilities studied, were grossly wanting in terms of staffing, equipment,
essential drugs and supplies. Both quality of care and record keeping were well below
acceptable standards.
Conclusions: The study findings are a sad but a fair reflection of our situation not only in
Kenya but also in sub8aharan Africa ten years after the declaration of the Safe Motherhood
Initiative (SMI). The results indicate a predictable, widening gap in basic service provision
that must be urgently bridged as a prerequisite to any serious and meaningful approaches
to reducing maternal mortality in Africa.
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