Maternal health and access to SRHR in Kenya
When assessing the progress made and achievements realized with the implementation of the MDGs, one thing is clear, as we strive to catch up with the MDG momentum, maternal health is not one of those achievements. MDG target 5b has not been met in many countries, according to UNFPA, Kenya’s maternal mortality rate remains at 488 per 100,000 live births. Maternal mortality in Africa remains unacceptably and unnecessarily high. This however is said cognizant of the fact that there is no necessary maternal mortality. In the 15 years of the Millennium Development Goals (MDGs), only a few countries in Africa have made notable gains in reducing maternal mortality – currently standing at 510 deaths per 100,000 live births. Question begs, despite the trending phrase, No woman should die while giving life, why are we still counting so many deaths of women, whose only fault is getting pregnant and desire to raise a child??
We know what works and yet we do not do it, this was one of the opening statements at one conference pegged on reviewing African health policy instruments expiring in 2015. This statement could be tweaked especially to speak to the status of maternal health in Africa. Maternal health can only be improved if only the simplest of interventions are put in place.
Dandelion Kenya is a grassroots organization based in Nakuru Kenya working to ensure that women and girls receive SRHR information and services. Dandelion Kenya also chairs the Women’s Global Network for Reproductive Rights Alliance Kenya(WAK), a network that advocates for access to safe abortion in Kenya.
Dandelion Kenya provides reproductive health information to women where they are, in our previous projects, working with women living with HIV. The Economic empowerment projects, mostly jewellery making from recycled paper would be coupled with lessons on reproductive health, access to family planning, safe sex negotiation skills and how to access ante natal and post-natal care. Projects with women groups varies from location to location and some include women selling illicit brew, for this women access to SRHR information is even much more needed given the risky nature of their business and the harassments that comes with. Most of them are forced to have sex with police men to avoid being arrested, and would incessantly be fighting off advances from their drunken customers. For women in Baringo at the Kokwa Island, they would rarely receive information on reproductive health due to the physical inaccessibility of their location.
The picture above illustrates the various needs and how women in different parts of the world face the maternal health equation in a unique manner. But one thing is clear, the most needy and those most at risk are the women living in poverty and least educated. Nipping poverty in the bud is the first step towards improving maternal health, 42% of Kenya’s population live in poverty despite this being an improvement from 59%.
Dandelion Kenya, apart from availing the information to the women also works with schools to avail comprehensive sexuality education. If adolescent girls are not informed of their human rights, sexuality, gender and power relations , HIV and especially empowered to be confident to claim their rights and lead healthy lives including ensure they access services and commodities such as sanitary towels for poor girls who require them to stay in school, we will not combat the high rates of maternal mortality.
Despite Kenya losing 21 women to maternal deaths every day and 7 of those are due to unsafe abortion, access to safe abortion in Kenya is restricted to a few provisions. These provisions have now been challenged with the withdrawal of policy standards and guidelines for providing safe abortion, this continues to promote negative service provider attitudes towards women seeking safe abortion services in the wake of increased anti-choice crusaders across the world and Kenya not exempted.
Campaigns like Beyond Zero by the first lady of Kenya have provided a platform to galvanize support towards ending maternal deaths. This support includes government, UN agencies, private sector and individuals. But one thing is clear, improving maternal health takes an effort of analysing the issue holistically. In Kenya unsafe abortions have been recognized as a secondary cause of maternal mortality. The laws address the effects by providing post abortion care but not root cause of unsafe abortion. Enabling access to safe abortion even within the provisions in our constitution that expanded and including to victims of rape would greatly enhance maternal health added onto already existing programs and interventions.
Some organizations work to train women how to provide access to medical abortion prescription to their counterparts in communities. These efforts however isolated avert unsafe abortions and the mortality that would come from it.
As we celebrate the upcoming International Maternal Health Day on April 11th , lets recognize women’s rights to health enshrined within the Beijing Platform for action and the ICPD program or Action. These rights include sexual and reproductive health and rights for which maternal health is a crucial part.
Let us stop seeing the world as it is for women but as it should be for every woman and girl.