Mandera Governor Mohamed Adan Khalif.
Kenya has lost at least 934 newborns in hospitals since the start of the year, raising alarms over maternal and neonatal care.
Governors have warned that the Ministry of Health’s decision not to fund deliveries at level-two facilities and clinics could reverse gains in reducing deaths of mothers and newborns across the country.
The Council of Governors (CoG) yesterday threatened to pull out of the Social Health Authority (SHA) if it does not streamline service delivery and fund grassroots health facilities.
“We are going to pull out of SHA if it continues with this behaviour of not reimbursing claims for level-two and even level-three hospitals. In our level-two and -three facilities, between January and July, we conducted 1,000 deliveries which went unclaimed. We want this matter addressed urgently,” said Mandera Governor Adan Khalif.
He added: “A dispensary in Mandera, at the border with Ethiopia, is like the Aga Khan and Nairobi Hospital of Mandera. Denying deliveries at dispensaries and health centres is retrogressive.”
The issue emerged during a meeting between the CoG, Ministry of Health, and Ministry of Lands, Public Works and Housing in Naivasha, Nakuru County, on Wednesday.
The governors say the SHA decision has already led to a drop in facility-based deliveries, undermining efforts to curb maternal and newborn deaths. They also expressed concern over unilateral decisions by Health Cabinet Secretary Aden Duale without consultation with stakeholders.
“SHA should urgently start funding level-two facilities. We want engagement with SHA and the Ministry of Health because, officially, dispensaries are not inpatient facilities, but pregnancy is not something that can be faked; the product is visible—a baby and a happy mother,” said newly elected CoG Vice-Chairman and Tharaka Nithi Governor Muthomi Njuki.
Tharaka Nithi Governor Muthomi Njuki at a past event.
Available records indicate Kenya’s neonatal mortality rate was 21 deaths per 1,000 live births last year.
Governors argue that for many mothers, especially in rural and remote areas, dispensaries remain the only accessible facilities for delivery.
They warned that lack of funding at grassroots facilities may derail ongoing initiatives, including the inter-county maternal and perinatal death surveillance and response (MPDSR) programme.
The Ministry of Health, however, maintains that there is no directive to stop reimbursing deliveries in any facility.
“Level-two facilities must upgrade infrastructure, human resources, and obtain licences. The Ministry is working with SHA and KMPDC to define provisions allowing deliveries where the need is determined, especially in counties with low facility densities,” a senior MoH official said.
The latest statistics show that Kenya loses approximately 5,680 mothers and 33,600 newborns annually. Maternal deaths stand at roughly 355 per 100,000 live births, translating to about 16 preventable deaths every day.
The Kenya Women Parliamentary Association (Kewopa) has highlighted persistent high rates of maternal and neonatal deaths, especially in rural and marginalised areas.
While improvements were noted in skilled birth attendance and postnatal care between 2008 and 2014, the rate of neonatal mortality reduction has largely stalled.
Healthcare infrastructure
According to the Kenya Demographic and Health Survey (KDHS), the current neonatal mortality rate of 21 per 1,000 live births falls short of the 2030 Sustainable Development Goal target of 12 per 1,000 live births.
Kewopa Chairperson Leah Sankaire called for urgent investment in healthcare infrastructure, skilled personnel, and essential maternal and neonatal care.
Leah Sankaire, Kewopa chairperson and Kajiado Woman Representative.
“We call for urgent investments in both maternal and newborn care, and dedicated funding to reduce maternal and newborn deaths nationwide,” she said.
The association emphasised the pivotal role of SHA in expanding healthcare coverage and ensuring quality care.
Ms Sankaire urged the Ministry of Health, National Treasury, and county governments to fund the operationalisation of Neonatal Intensive Care Units (NICUs) in all 47 counties, noting current coverage stands at 37 per cent.
She further called for SHA coverage to include postnatal care for up to 28 days, including vital interventions such as phototherapy, oxygen, and IV fluids.
The association also commended government investments in oxygen infrastructure, which have enhanced emergency care for children with pneumonia.
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