Kenya is witnessing a worrying decline in hospital births, with county leaders warning that a recent Ministry of Health directive is putting mothers and newborns at risk.
Since the start of the year, at least 924 women and roughly 10,000 newborns have died in hospitals, numbers governors say reflect the pressure created by the current policy restricting maternity services at level two facilities.
Governors are challenging the ministry’s reasoning, which cites insufficient admission beds at dispensaries. They argue that for many mothers, especially in remote and rural areas, these facilities remain the only accessible option for delivery.
“One of the reasons why I engaged SHA and the CS is that officially, dispensaries are not supposed to be inpatient. You can fake any other disease, but I don’t see anyone faking pregnancy because there is a product visible, a baby and a happy mother,” Tharaka Nithi Governor Muthomi Njuki stated on Thursday.
Mandera Governor Mohamed Adan Khalif added: “Dispensary in Mandera at the border of Ethiopia in the north is Aga Khan and Nairobi Hospital of Mandera. Now, when you deny deliveries at dispensaries and health centres, we are not progressing; actually, we are retrogressing.”
The comments came during the launch of the inter-county maternal and perinatal death surveillance and response initiative (MPDSR), a system designed to track maternal and newborn deaths in real time and enable counties to share data, successes, and challenges.
Governors insist that delays and reductions in SHA disbursements are worsening the situation.
“What we did this financial year, we invested more in equipping our hospitals hoping that the money and resources we generate will support us in these issues. But when a county referral receives Sh1.2 million in disbursement, then you can imagine what we are looking at,” Governor Khalif said.
The ministry maintains it has not issued a directive to stop maternity reimbursements at any facility. However, it notes that level two facilities are not licensed for inpatient services under KMPDC rules and must upgrade infrastructure to safely handle deliveries.
Discussions with SHA and KMPDC are ongoing to define where deliveries can take place, particularly in counties with limited access to hospitals.
Governors warn that restricting maternity services at dispensaries has already reduced the number of women seeking skilled care, leading to more home births and higher maternal and newborn deaths.
Data from the newly launched MPDSR dashboard shows 924 maternal deaths and around 10,000 newborn deaths since January, underscoring the need for urgent collaborative action between counties and the national government.
The council also notes that the directive has deprived level two facilities of about Sh2.5 billion in SHA funds, weakening the very facilities mothers depend on. Skilled birth attendance has dropped in some counties—for example, Kisumu fell from 89 percent to 69 percent, and Nairobi declined from 100 percent to 80 percent last year.
The Council of Governors emphasized that the issue is not a conflict between national and county governments but highlights the need to treat health as a devolved function while ensuring safe deliveries for mothers and newborns.
