MATERNAL MORTALITY IN KENYA: THE STATE OF HEALTH FACILITIES IN A RURAL DISTRICT

Background: This study was formulated from the premise that the known causes of maternalmortality, namely haemorrhage, sepsis, obstructed labour and abortion belie the morefundamental development problems that influence it, such as the state of local medicalservices, 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 toinfluence 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 offunction, and factors influencing their utilisation. Both qualitative and quantitative methodsof data collection tools were used.Setting: Siaya District in the western region of Kenya. Data were collected from thirtyfacilities, which provide obstetric care in the district.Participants: Data were collected by nurselmidwives, nursing school tutors and socialscientists with experience in qualitative research methods. Respondents included healthservice providers and managers at the 30 health facilities. Qualitative data were obtainedthrough 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 belowacceptable standards.Conclusions: The study findings are a sad but a fair reflection of our situation not only inKenya but also in sub8aharan Africa ten years after the declaration of the Safe MotherhoodInitiative (SMI). The results indicate a predictable, widening gap in basic service provisionthat must be urgently bridged as a prerequisite to any serious and meaningful approachesto reducing maternal mortality in Africa