The Role of KNH/UON in Accelerating
the Achievement of MDGs 5 and 4
MNCH Symposium
10 January 2013
Dr. Gathari Ndirangu
Reproductive Health
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MDG 5 in Kenya
• MDG 5 is off target
– MMR target: 147/100,000 live births by 2015
– Universal access to RH
– Current MMR: 488/100,000 live births*, up from 414 in
2003**
• Newborn part of MDG 4 has stagnated
– Neonatal mortality rate 31/1000 live births*
– 60% of IMR
• Commendable progress in the other MDGs
(especially 1, 2, 3)
*KDHS 2008-09
**KDHS 2003
Socioeconomic Determinants of
Maternal Mortality
• Illiteracy, poverty and poor women
empowerment
• Pregnancy too soon, too frequent, too many
• Inadequate access to RH/MNH/FP services
• Delivery under unskilled care
• Limited accountability at all levels
Policy Environment
KNH’s Strengths to Accelerate
Achievement of MDG5
• Strategic objectives to fulfil national mandate, vision
and mission
– To improve quality specialized reproductive healthcare
– To reduce maternal and perinatal morbidity and
mortality
– To enhance training and research
– To contribute to national RH planning and policy
formulation
– To strengthen institutional linkages and collaboration
– To contribute to corporate social responsibility and
improve on hospital image
MNH Strategic Objectives
• Reduce maternal and perinatal morbidity/mortality
– Service provision from primary to tertiary care
– PMTCT program
• Training and research
– Graduate and undergraduate levels, paramedical
– Vibrant and respected research community
– Translation of research into policy and practice
• Contribute to national RH planning and policy
formulation
• Institutional linkages and collaboration, including PPP
Challenges
• Heavy client load (outstrips capacity)
– Non-booked ANC clients (~60%)
– Late referrals
• High MMR
– 1223/100,000 LB (Jan-Nov 2012)
• High NMR 116/1000 LB (Jan-Dec 2012)
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Prematurity
NN Sepsis
Term RDS
Birth asphyxia
KNH’s Opportunities for Improving MNH
Indicators
• Highly trained workforce
• Favorable policy environment
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National referral hospital
Devolved governance
Strengthen lower tier health care facilities
Effective knowledge and skill transfer
Mentorship
Timely and supportive feedback to referring HCFs
Satellite health care facilities
Modern technology
KNH’s Opportunities for Improving MNH
Indicators
• Proactively creating modalities to realize full
potential in MNH services
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Advocacy
Participation in national RH planning including MPDSR
Training
Research
Collaboration including PPP
• Provision of full range of FP services (LAPM)
• Timely reporting to the national HMIS for national
planning
Threats
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Political interference and uncertainty
Poverty
Inadequate financial resources
Commodity insecurity/inadequate equipment
Increased litigation
Industrial strife
Inadequate health workforce
National Vision 2030 MNH target
• MMR- 113/100,000 LB (77% reduction)
– From 1223 to 281/100,000 LB
• NMR- 13/1000 LB (59% reduction)
– From 116 to 47/1000 LB
• Together, we are up to the task!