By the time the road winds its way down into Makueni County, a woman somewhere in Kenya has already lost her life to a pregnancy-related complication. It happens 15 times a day in this country, and most of those deaths did not have to happen.

That is the reality that brought together health experts, community members and leaders at Makueni County Referral Hospital yesterday, for the first Maternal Health Series hosted by Nation Media Foundation, to ensure that no woman loses her life while giving life.

Besides women, Kenya also loses about 92 newborns every day, and more than 90 mothers go home without their babies because of stillbirth.

Makueni County was selected strategically because of the initiatives the county has undertaken to ensure that women leave its hospitals alive and with their babies. Over the past four years, the devolved unit has been running a pilot project funded by Unitaid and implemented by Jphiego, to prevent maternal deaths caused by post-partum haemorrhage (PPH). The project started in 2022.

The funders trained healthcare workers, procured new prevention drugs for PPH and included calibrated drapes in maternity wards to help clinicians tell when a woman has lost so much blood that it could result in death. Kenya was one of six countries included in the project, alongside the Democratic Republic of Congo, Guinea, Nigeria, India, and Zambia.

Since the project rolled out, the county has been recording zero maternal deaths linked to post-partum haemorrhage, except for last year, though county officials attribute those deaths to other pregnancy-related complications.

The project ends this July, but Joyce Mutua, the County Executive Committee member in charge of Health, assured those present that the County Government of Makueni would fund its continuation.

“We are already procuring commodities; we should not worry about what happens next,” she said.

The county allocates about 38 per cent of its budget to health, and about 70 per cent of that budget goes to payment of salaries to staff, according to Dr Harvey Mbithi, Makueni County’s Chief Officer for Health Human Resource Management and Administration. He noted that even though health is a devolved function, funding from the national government is not always sufficient to cover all health projects.

Nation Media Group’s (NMG) Chief Corporate Affairs, Marketing and Partnerships Officer, Monicah Ndung’u, set the tone during the opening session, saying the goal of the series is to shape progress in maternal health outcomes across the country.

“Today’s gathering reminds us that maternal health is not only a medical issue, but a shared responsibility that calls for awareness, accountability, and action from all of us. When communities, experts and leaders come together, change becomes possible, and that is how we continue positively influencing society,” she said, adding that NMG’s role in storytelling creates a noticeable impact that can shift the statistics on preventable maternal deaths.

“Maternal health is not just a health issue; it is also a systems issue,” she said.

In her keynote address, Dr Hellen Barsosio, a clinical research scientist on maternal and newborn health at the Kenya Medical Research Institute (Kemri), reminded those in attendance that while the drugs helped in reducing maternal deaths, the people who define the system, including midwives and specialist doctors, played a major role.

“You must build your way to zero mortality. Let’s start planning as a country and allocate funds to support mothers and babies; to hire nurses, buy more drugs, train nurses,” she said, adding that mothers die when they do not know the danger signs, with delays in seeking care attributed to issues such as bad roads or fewer emergency services.

“Each death is a family that is permanently altered. Every preventable death is an act of leadership,” she said.

Christine Wanjiru, a nurse-midwife who coordinates reproductive health services at Makueni County Referral Hospital, said her team can now manage PPH with far greater confidence.

“We are no longer scared of PPH because we can now manage it. We are also working on the referral system because now we understand the urgency of a mother with PPH and what to do before even the ambulance comes,” she said.

“We have helped mothers to cut down their costs since the length of stay in their hospitals becomes shorter,” she added, noting that treating PPH is more expensive than managing it.

Dr Julie Nyanchama, a Senior Research Scientist at Kemri, said that if women are able to get timely, quality healthcare within a facility, more mothers will be saved.

“Women are coming to the hospital when it is almost too late. We still insist that quality antenatal care goes a long way in improving the overall pregnancy of a mother,” she said.

“Health financing is also important. We need the Social Health Authority to finance antenatal care visits even at higher-level facilities like Level 4,” she said. “We need the government to ensure that there is staff retention since most skilled nurses and midwives are now leaving the country for greener pastures.”

Freda Nyaga, regional monitoring and evaluation research adviser at Jphiego, said that together with the county, they have already figured out the project’s sustainability beyond the implementation period. What started as a pilot covering about 36 facilities has expanded to about 63, where healthcare workers are trained in how to prevent post-partum haemorrhage-related deaths.

“When we came here, the statistics were not looking good in terms of deaths due to PPH. We had to influence healthcare providers to ensure that no woman dies,” she said, adding that the programme also developed community health messages to raise awareness of PPH danger signs so that even inside a hospital, a woman who is bleeding can call for help and get it quickly.

Before the panel discussion, Nation organised a community baraza where local voices had their say. Community health promoters, boda boda riders and local leaders shared their experiences of the maternal health system, pointing out what is working and what is still failing women.

Among those who spoke was Noah Bakari, an Imam from Kibwezi East. More than 20 years ago, his wife had a stillbirth and he almost got into depression.

“There were a lot of blame games and traditional issues, but my wife got pregnant again. Our child is now 23 and is already working, that is how I started getting involved in health advocacy issues,” he said.

Jane Ndawa, Assistant Chief of Kikumini, told the gathering that losing a mother or a child leaves the whole family incapacitated.

“Women should attend antenatal clinics when they are pregnant so that any complications can be handled in good time,” she said.