16 lives lost daily: Kenya hosts historic conference to stop preventable maternal deaths

By the time the clock strikes midnight tonight, at least 16 women will have lost their lives in Kenya from causes that are entirely preventable such as severe bleeding during childbirth.

Globally, that number exceeds 200 each day, even though this type of death is preventable with known interventions.

According to the World Health Organization (WHO), when a woman loses at least 300 milliliters of blood while giving birth, it qualifies to be classified as post-partum haemorrhage (PPH).

In response, health professionals and researchers from Kenya, Malawi, Rwanda, Uganda, Tanzania, Zambia, and the United Kingdom are convening in Nairobi on July 22–23 for Africa’s first-ever conference dedicated solely to PPH. 

Hosted by Kenya’s Post-Partum Haemorrhage Foundation in partnership with the Ministry of Health, the Kenya Obstetrics and Gynaecological Society, and other allies, the meeting aims to improve knowledge sharing in order to drive down Africa’s preventable maternal death toll.

Also read: 16 women die every day: Kenya declares war on maternal mortality

Dr Ouma Oluga, PS for Medical Services, reaffirmed Kenya’s ambition to cut maternal deaths by at least 80 per cent within the next two years.

“The clock is ticking towards 2030, and there is no time to argue about whose responsibility it is. Action is what we need. We call upon everyone to put in their resources and deliver the critical commodities required to save our,” he said.

Dr Oluga reminded clinicians that beyond their profession, they should be human and treat mothers with the dignity and respect that they deserve, one which he said is the foundation for the medical profession.

Dr Oluga shared that the number of women who continue to die shows something is still amiss and that needs to change.

“It is a depressing situation that every single evening, we still lose up to 16 mothers. In the last three weeks, we have lost up to 92 mothers from preventable deaths. As we work to look at the root causes, it is important to share these realities with everyone,” he said.

Dr Oluga also noted that the Ministry of Health has established a secure pipeline for essential commodities to ensure facilities are stocked with life-saving supplies. For the first time, the government has invested more than 1.5 million doses of a drug called heat stable carbetocin which is widely regarded as a game-changer in PPH prevention.

Dr Kireki Omanwa, consultant obstetrician and gynecologist and president of the Kenyan Obstetrics and Gynecological Society, said the number of women dying due to PPH is devastating.

To help in reducing these deaths, the PPH foundation now has a first-in-Africa virtual reality school which is at the forefront of reskilling and retooling health workers by giving them simulation activities for a PPH scenario that will improve their confidence to handle such cases.

Additionally, every September 27th, the foundation organises a community run not only to raise awareness about PPH but also to collect blood specifically reserved for pregnant mothers in need.

On the frontlines, Eunice Atsali, vice-president of the Midwives Association of Kenya and a nursing lecturer at Kenyatta University, emphasised that skilled midwives are only part of the equation. Facilities must also be equipped with functional tools and dependable drug supplies, especially at primary care level.

“Post-partum haemorrhage is a scary situation for any midwife, but then it changes if the midwife is skilled and they have what to use, especially at the primary healthcare facilities,” she said.

She pointed to a new study published by the Lancet which recommends that clinicians can use a combination of two drugs that prevent excessive bleeding impacts for a better outcome.

However, stockouts of these drugs remain common in many settings. Even when drugs are available, those requiring cold-chain storage often lose potency due to temperature fluctuations.

"As midwives, we continue to advocate for essential commodities. Recently, however, we have noticed stock-outs of heat-stable carbetocin despite having fought to ensure it was included in our national policies and protocols," she said.

She added that early identification of potential postpartum cases is equally critical so that preparations can begin before the situation escalates.

According to current guidelines, clinicians are expected to quantify the exact amount of blood a woman loses during delivery. New tools, such as the calibrated drape approved by the World Health Organization, have been introduced in the country, but most counties still lack them.

"My experience, even when assessing my students, is that calibrated drapes are only visible in pilot study sites. I don't see them being used in routine care," she said.

This means that most healthcare workers still rely on visual estimation to gauge blood loss, a practice that is deeply flawed.

In a virtual presentation at the conference, Prof Arri Coomarasamy, a renowned Professor of Gynaecology and Reproductive Medicine at the University of Birmingham and the University of Oxford, who has led numerous global studies, cited the CHAMPION trial, which found that visual estimation misses up to 47 per cent of PPH cases.

"It doesn't matter how well trained you are. If you rely on visual estimation, you will likely miss PPH," he warned.

Atieno Jalang'o, Africa Coordinator at Fering Pharmaceuticals for the public-sector rollout of heat-stable carbetocin, described the drug as particularly suited to the African context. Its heat stability, longer duration of action, and independence from cold-chain storage make it a practical solution in low- and lower-middle-income countries like Kenya, where refrigeration remains a major constraint.

Fering, in partnership with WHO and other development allies, supplies the drug with the goal of reducing maternal deaths during the third stage of labour.

"In Kenya, heat-stable carbetocin is now available in all counties, but universal access across all facilities has not yet been achieved. We've helped catalyse uptake through training and supply chain optimisation," she said.

She noted that financing remains a major hurdle in most countries, including Kenya. Additionally, the lead time from ordering to delivery is roughly seven months to a year, a long gap for a drug in high demand.

Jalang'o told the Nation that data from their rollout shows significant impact. In Turkana, for instance, PPH cases dropped by 90 per cent, while Mombasa recorded a 52 per cent reduction.

She reassured that a mother who experiences uterine atony, where the uterus fails to contract, will receive heat-stable carbetocin, giving her a strong chance of leaving the hospital alive. However, she cautioned that if the bleeding stems from causes other than atony, the drug alone may not be sufficient.

"The most important step now is for the government to examine county-level data, use it to quantify actual needs, and procure accordingly," she said.

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