NAIROBI, Kenya — Governors have raised alarm over a sharp decline in health-facility deliveries in rural areas following a Ministry of Health decision to halt reimbursements for births conducted in level two facilities and dispensaries, a move they say is endangering thousands of expectant mothers.
According to the Council of Governors (CoG), the withdrawal of funding has already contributed to a worrying drop in skilled deliveries, with at least 924 mothers and 10,000 newborns reported to have died in various hospitals since January — a figure county leaders say underscores the urgency of restoring support to frontline health centres.
The Ministry of Health has reportedly argued that many dispensaries lack the beds and infrastructure required to offer inpatient maternity care. But governors say that in vast swathes of rural and remote Kenya, dispensaries are the first — and often the only — accessible health facilities for women in labour.
“You can fake any other disease, but I don’t see anyone faking pregnancy because there is a product visible — a baby and a happy mother,” Tharaka Nithi Governor Muthomi Njuki said, questioning why the ministry would deny reimbursements to facilities that communities rely on.
Mandera Governor Mohamed Adan Khalif said the directive threatens to roll back years of gains in maternal health, especially in border counties. “Dispensary in Mandera at the border of Ethiopia is Aga Khan and Nairobi Hospital of Mandera,” he said.
“When you deny deliveries at dispensaries and health centres, we are not progressing; actually, we are retrogressing.”
The governors spoke during the launch of the Inter-County Maternal and Perinatal Death Surveillance and Response (MPDSR) initiative, which seeks to strengthen reporting, analysis, and coordinated action across counties to reduce preventable maternal and newborn deaths.
They accused the ministry of politicising the Social Health Authority (SHA) and delaying critical reimbursements.
Khalif cited an example in which a county referral facility received only Sh1.2 million, an amount he said was far below what hospitals need after counties invested heavily in equipping their facilities in anticipation of timely payments.
Kenya continues to grapple with high maternal mortality, losing 5,680 mothers and 33,600 newborns every year, despite strides in antenatal care, skilled deliveries, and emergency obstetric services.
Health experts say the withdrawal of support for level two facilities risks worsening these numbers, especially where distances to higher-level hospitals are vast and transport remains unreliable.
But the Ministry of Health has denied issuing a directive stopping payments for maternity services, insisting that all facilities remain eligible for reimbursements.
It maintained, however, that level two centres are not licensed for inpatient care under the Kenya Medical Practitioners and Dentists Council (KMPDC) regulations and must upgrade their infrastructure to comply with the Kenya Essential Package for Health (KEPH) standards.
The ministry said it is working with SHA and KMPDC to develop provisions that would allow deliveries in lower-level facilities “where need is determined,” particularly in counties with low facility density or poor road access.
Governors are urging the national government to reinstate full reimbursements immediately, warning that delays threaten to undo years of progress in reducing preventable maternal and neonatal deaths.
The newly launched MPDSR framework is expected to provide real-time data, coordinated interventions, and county-to-county collaboration — a move they hope will save lives as both levels of government negotiate a long-term solution.
