Independent Evaluation of the Reduction of Maternal and Neonatal Mortality in Kenya: Formative Evaluation Findings

Abstract

Too many women in Kenya are dying in childbirth. Too many newborn babies don’t survive the first month of their lives. The Government of Kenya is responding with support from international partners. Since 2013, maternity services have been provided free of charge by government hospitals and health centres. However, many challenges remain. There is a strong tradition of home deliveries and hospitals or health centres are often far away. The roads to reach the health centres may not be safe at night, or the fare for the taxi may not be affordable. Throughout the country there is a severe shortage of trained doctors and midwives and many health centres are poorly equipped and may not even have electricity or running water. The DFID-funded Reduction of Maternal and Neonatal Mortality Programme (MNH Programme) started to address these issues in 2014 with a grant of £75.3 million over five years. It is active in six counties, home of nearly one quarter of the Kenya’s population of about 48 million. The midterm evaluation in 2016 found that the MNH Programme addresses some key causes of maternal and newborn health with an appropriate mix of interventions to strengthen the Kenyan health system at all levels, including in the communities. The implementation of some MNH Programme components started late. Training of doctors and midwives in emergency obstetric care was one of the first sets of activities to get underway, and it has started to show results. In 2016, it was, however, still too early for a robust assessment of the number of deaths averted by the programme. Nevertheless, the information collected and documented by the evaluation will serve as a valuable baseline on which such an assessment can be made in 2018 when the 5-year MNH Programme will be nearing its end.