No woman should die giving life: Makueni’s blueprint for ending maternal deaths
A mother carries her newborn. Makueni County has introduced lifesaving innovations to prevent maternal deaths.
What you need to know:
- Makueni’s success shows that political will, innovation and data-driven care can drastically reduce preventable maternal deaths.
- With the right tools and training, postpartum haemorrhage no longer has to be a leading killer of mothers.
Following the International Maternal Newborn Health Conference 2026 hosted in Nairobi in March, the world's attention turned to a question that should trouble us all: Why are women still dying while giving life?
In Kenya, postpartum haemorrhage – severe bleeding after childbirth – remains the leading cause of maternal death. For years, this was our reality in Makueni County. But today, Makueni has turned the corner.
In 2022, we lost 12 mothers in our public facilities to postpartum haemorrhage. By 2023 and 2024, that number had dropped to zero. In 2025, we recorded three deaths. For every woman's life saved, a family is preserved, futures are protected, and a community thrives.
The Makueni transformation did not happen by chance. As the National PPH Champion and an honorary member of the Kenya Obstetrical and Gynaecological Society (Kogs), I have seen what is possible when leadership, innovation, and partnership align behind a single goal: saving mothers’ lives.
In Makueni, we took a bold step. We piloted a comprehensive package of quality-assured interventions to prevent and treat postpartum haemorrhage. Working closely with Jhpiego through the AMPLI-PPHI initiative, supported by Unitaid, alongside Path, Kogs, and Figo, we introduced lifesaving innovations, including heat-stable carbetocin, tranexamic acid, and calibrated drapes that enable early detection and rapid response.
We replaced guesswork – what many called the “Macho-meter” – with precision. And in doing so, we saved lives. But tools alone do not save lives. We must ensure innovations reach the people who need them most and are embedded in existing systems.
We trained health workers through practical, high-frequency simulations. We strengthened teamwork in maternity wards. We reviewed every maternal death and near-miss to improve response. And we invested our own county resources to scale these interventions from 36 facilities to all 242 public birthing centres.
The results have been profound: fewer referrals, fewer blood transfusions, and faster clinical response. Most importantly, more mothers are going home alive. We also recognise the important role of wanahabari in supporting journalists to tell these stories from a solutions-driven perspective – ensuring that progress is documented, shared, and inspires action beyond our borders.
Nationally, this momentum is growing. Coordinated efforts between the Ministry of Health and partners have led to policy reforms, expanded access to lifesaving commodities, and a dramatic reduction in the cost of heat-stable carbetocin – from Sh2,700 to just Sh95 – unlocking access at scale. Yet, even as we celebrate progress, we must confront reality.
Maternal mortality in Kenya remains high at 355 per 100,000 live births, while neonatal mortality stands at 21 per 1,000. These figures remind us that postpartum hemorrhage is only part of the challenge.
Conditions such as preeclampsia and eclampsia continue to threaten mothers’ lives. Maternal anemia remains a silent but significant contributor. In Makueni, we learned that access alone is not enough—many women were not taking supplements due to side effects. In response, we are now piloting Multiple Micronutrient Supplementation to improve adherence and outcomes.
At the same time, declining donor funding presents a new reality. The future of maternal and newborn health will depend on stronger domestic investment, better coordination, and sustainable systems. It is in this context that the theme of the International Maternal Newborn Health Conference 2026, “Moving forward. Together’, could not be more timely.
Globally, progress in maternal and newborn health has slowed, and preventable deaths persist. But the solutions are within reach. What is needed now is urgency, accountability, and the courage to scale what works.
From Makueni, we offer three lessons to the world: First, political will saves lives. When leaders prioritise maternal health, systems respond. Second, innovation must reach the last mile. A breakthrough drug means nothing if it is not available in the delivery room. Third, data must drive action. Every maternal death must be counted and used to improve care.
It is important that we move beyond commitments to implementation. Let us ensure that every policy decision, every budget allocation, and every partnership translates into one simple outcome: a mother surviving childbirth. Because no woman should die while giving life.
Maternal death is not a clinical issue; it is a political issue. Leaders must stand up and be bold to say women’s lives matter. And as Makueni has shown, with the right choices, she doesn’t have to. From Makueni, we call on the nation and the entire African continent to join us as we move forward—together.
The writer is the governor of Makueni County.
