NAIROBI, Kenya – Despite steady gains in healthcare access, Kenya continues to record one of the highest maternal mortality rates in East Africa, a new government assessment has revealed.
The Kenya Health Facility Assessment 2024: Quality of Care and Human Resources for Health Report shows that while more women can now reach health facilities for childbirth, the quality of care they receive remains inconsistent and often inadequate.
According to the report, which assessed 3,605 health facilities across all 47 counties, only 37 per cent of facilities offering delivery services had all seven Basic Emergency Obstetric and Newborn Care (BEmONC) functions.
Among higher-level hospitals (Level 4 and 5), less than half — 46 per cent — could provide the full range of Comprehensive Emergency Obstetric and Newborn Care (CEmONC) services, leaving many mothers without timely, lifesaving interventions during labour and delivery.
“The mismatch between diagnosis and treatment significantly contributes to preventable maternal deaths,” the report notes, citing widespread shortages of essential drugs, poor adherence to clinical guidelines, and gaps in health worker training.
Poor Treatment and Drug Shortages Undermine Progress
The report paints a troubling picture of inconsistent care across Kenyan hospitals and clinics.
Only 40 per cent of childbirth emergencies, such as postpartum haemorrhage, were correctly managed, while treatment for birth asphyxia — a leading cause of newborn deaths — was appropriate in just 36 per cent of cases.
Frequent drug stock-outs and shortages of laboratory supplies have further worsened the situation, especially in rural and lower-tier facilities.
These disruptions have hampered the management of pregnancy-related complications and neonatal emergencies.
Human Resource Crisis Deepens Inequities
Kenya’s health workforce remains severely overstretched. The report shows the country has only 14.3 core health workers per 10,000 people, far below the World Health Organization’s recommended 23 per 10,000 needed to achieve universal health coverage.
Only four counties — Nairobi, Mombasa, Kisumu, and Nyeri — meet that benchmark. In the rest, severe shortages of skilled birth attendants and obstetric specialists continue to drive maternal deaths.
Absenteeism is also widespread. The report found that nearly 30 per cent of health workers were absent during unannounced visits — often due to strikes, illness, or personal reasons — leaving many maternity units understaffed or run by inadequately trained personnel.
Unqualified Facilities Performing Surgeries
The assessment also exposed systemic lapses in regulation. Some lower-level health centres (Level 2 and 3) are performing major surgeries, including Caesarean sections, despite lacking the infrastructure, equipment, and expertise for such procedures.
“Most of the misaligned facilities are private, and their service expansion without adequate capacity increases the risk of poor maternal outcomes,” the report warns.
Call for Urgent Reforms
To close these gaps, the report recommends a national strategy to reclassify misaligned facilities, strengthen supervision and accountability, and ensure equitable distribution and retention of health workers.
It also calls for continuous professional training, better adherence to clinical guidelines, and stronger governance systems to curb absenteeism.
The Ministry of Health is further urged to enforce postpartum monitoring standards and improve documentation of vital signs and treatment records — critical steps in preventing deaths from haemorrhage, sepsis, and other avoidable causes.
While Kenya has made progress in expanding access to healthcare, the report concludes that quality, not just quantity, must be the next frontier.
“Investments in health must translate into improved outcomes and client satisfaction,” it states. “Until Kenya bridges the gap between diagnosis and treatment, ensures consistent drug availability, and strengthens its health workforce, maternal mortality will remain a tragic reflection of systemic inequities.”
