Over the last decade, Kenya has made progress to reduce the Maternal Mortality Ratio (MMR). Today, World Bank data puts Kenya’s MMR at 530 deaths per 100,000 live births. These lives of women and girls lost during pregnancy and childbirth can be saved.
County governments in Kenya still record higher MMR. This therefore cut-out the work of advocates who champion for survival of women and girls. Evidence for Action (E4A)-MamaYe works in two sub-national regions in Kenya. These are the Nairobi City County and Bungoma County. Despite disparities in the socio-economic and political situation, there are great similarities on key challenges contributing to loss of lives for women and girls during pregnancy or childbirth.
Grassroots advocates taking lead
In these two regions, we support civil society organisations through their coalitions. Over the years, E4A-MamaYe has equipped them with knowledge, skills, tools and resources to become effective advocates for maternal and newborn health. These coalitions have identified teenage pregnancy, low uptake on Antenatal care (ANC) services and a weak referral system as priority root causes for deaths of women and girls.
According to the national Demographic Health Survey (DHS) of 2022, teenage pregnancy rate in Kenya stands at 15%. This means that in every 10 girls aged 15 to 19 years in Kenya, 1 girl is pregnant and at a greater risk of losing their life.
Bungoma records a much higher rate than the national average at 18.6% while Nairobi is making progress reducing this to 8.6%.
In Kenya today, 7 out of 10 women have had four or more ANC visits for their most recent live birth or stillbirth. Still, there is work to be done to ensure every woman and girl has information and access to quality services during pregnancy.
Since the coalitions started advocating for the improvement of the key issues identified, they have seen some positive progress. For example, in the 2023/24 financial year County Annual Work Plan (AWP) in Bungoma County, an allocation of Kes. 400,000 ($ 2,800) to support the county to conduct Quarterly Maternal and Perinatal Death Surveillance and Response (MPDSR) review meetings while Nairobi allocated Kes. 600,000 ($ 4,200). These meetings are important because they audit the maternal and perinatal deaths to prevent similar deaths in the future and improve quality of care.
There has been an increase in the budget for family planning commodities from the previous Kes. 300m ($2.3m) in financial year 2022/2023 to Kes 400m ($3m) in the current financial year (2023/24) in Nairobi County. In Bungoma, the coalition advocated for the inclusion of family planning (FP) commodities budget in the AWP for FY 2023/2024 to address the problem of high teenage pregnancy. Bungoma county included Kes. 40m ($ 285k) allocation for the pharmaceuticals which also include FP commodities. The county of Nairobi allocated Kes. 1m ($ 7,000) to help facilitate implementation of interventions related to the Youth Programme as a result of the MNH Association advocacy efforts in the AWP process of 2023/24.
In their advocacy, the coalitions have nurtured some beneficial partnerships with key stakeholders from government and non-government quotas. Moses Ouma from RMNCAH Network in Bungoma says,
“RMNCAH Network has become part of reliable stakeholders for MPDSR processes in the department of health and sanitation in Bungoma County. The Network has engaged in MPDSR reviews for sub counties and the community to pick key action points for follow up.”
Through E4A-MamaYe support, these coalitions have mastered data generation and packaging evidence to support their calls to action around their priority issues.
Looking into the future
To ensure that the coalitions put into practice the knowledge and skills acquired, E4A-MamaYe has provided a seed grant since May 2023. This grant helps them implement their advocacy plans independently. To ensure a collective approach on their advocacy in Nairobi City County, the MNH Association has organized workshops to train other civil society members on health budget advocacy using the health budget advocacy (HBA) toolbox. The HBA toolbox is developed by E4A-MamaYe and listed online as a Global Public Good (GPG) to support advocates across the world build their capacity.
At regional level, both Kenya coalitions supported by E4A-MamaYe and other organizations are closing ranks beyond the borders and have now formed the MamaYe Collective.
This Collective will provide an advocacy platform at regional level to hold governments accountable on their commitments and ensure survival of women and girls is on top of the political commitment across Africa. This will also provide an avenue for peer-to-peer learning and knowledge sharing on effective advocacy approaches and tools- including the E4A Global Public Goods.