Our mothers raise our nation, and yet too many of them are left to suffer in silence at their most vulnerable time of childbirth, due to inadequate or inaccessible public maternity services. In order to reduce maternal deaths and stillbirths, the Government of Kenya’s Free Maternity Service policy abolished the user fee for maternity care in 2013. However, over 35,000 stillbirths occur each year[1] and over 6,000 Kenyan mothers die annually from preventable maternal causes. According to a policy brief on a Demographic and Health Survey (2009) 

 “Last year, early morning when doctors were on a go-slow (strike), we were called to go help a woman who was in labour just outside Korogocho Health Centre... the health officers were inside the facility. Unfortunately, the baby was delivered outside the hospital, and due to the cold morning, it passed away.” -  Community Health Volunteer, Korogocho Nairobi

More than 328,000 girls got pregnant in the first year of the pandemic, according to Ministry of Health records. Many of these pregnancies were the result of transactional sex for food or menstrual hygiene products, and defilement (rape of a minor). Many levels 1-3 public health facilities are not properly equipped, nor are their personnel adequately trained to provide maternal care to minors, especially in those cases which occur from defilement. This can lead to health complications and threaten the lives of mothers and babies.

Many women also work on the frontline of our health system, in our homes and in communities, as community health “volunteers” (CHVs) – working as first respondents, providing needed healthcare services that our formal health systems are unable to deliver.

Since the MoH home-based isolation and care guidelines were passed in 2020, this work has increased and become more dangerous for our CHVs. They can spend upwards of 16 hours per week treating ailments and illnesses, delivering babies, and providing maternal and newborn healthcare, making home visits and delivering health promotion messages – often without any pay, no PPEs, and with inadequate training for the challenges they encounter.

“Kazi tunafanya ni ngumu sana na haina malipo. Saa zingine, juu kila mtu ako na households zake mia, kumenyesha, hauna gumboots, hauna umbrella, hauna raincoat. Umetembelea mtu...umekuta...accidentally mtoto kichwa imetoka, hauna gloves, hauna makasi, hauna uzi ya kufunga ile kitovu.’’ - Peris Nyakio, Community Health Volunteer, Kawangware - Nairobi

Our Prayers:

For the millions of Kenyan mothers and girls who rely on public hospitals for safe and dignified maternity services, and the countless community health volunteers providing life-saving care on the frontline of our health system, we urgently demand that the Government of Kenya, including Members of the Nairobi County Assembly, County Health Management Committees, the Min. of Health, National Treasury, National Assembly Health Committee, Min. of Gender, National Gender and Equality Commission, and Council of Governors:

1.      Allocate adequate personnel and resources to provide maternity services (antenatal, prenatal) services in all levels 1-3 public health institutions.

2.      Allocate adequate resources at a national and county level to give public health institutions the necessary training, personnel, and equipment to attend to underage pregnancies and pregnancies that occur from defilement.

3.      Allocate adequate personnel and resources to provide accessible and affordable mental health and counselling for teenage mothers and survivors of defilement.

4.      The Parliament of Kenya to fast-track the Community Health Services Bill, 2020 and the Nairobi City County Government to promptly implement the Nairobi City County Community Health Services Act, 2019. These laws and other policy guidelines will provide financial allocations for the payment, training, and proper equipping of Community Health Volunteers (CHVs).

a.       CHVs require training to handle certain diseases such as Tuberculosis, and the precautions that need to be adhered to to protect themselves.

b.      There is a need to adopt the Makueni County strategy on training CHVs' in Maternal Health Care (MTC) to reduce child mortality and safeguard the lives of both the mother and the child.

c.       CHV’s require adequate PPEs to carry out their duties. They also need security, especially when providing care at night, and due to the increased incidences of sexual violence and assault.

5.      CHVs spend the time they would otherwise spend on economic activities to support community members’ health needs. Therefore, they require compensation/facilitation to cater to their basic needs.