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celebrating improved maternal health in Mandera

Governor Roba inspects the newly constructed modern maternity wing at
the Mandera County Referral Hospital. Inset: Aerial view of the facility.

efore devolution, Mandera County had ity and empower women, with the specific goal stetric equipment to all health facilities in the
the worst health indicators that were not of reducing child mortality rate. The strategy county. Presently, 80% of our health workers
Bonly below the national averages, but fell also dovetailed into the National Reproductive are locals, and this has led to significant re-
way off global indicators as well. Health Policy and Vision 2030. The objective duction in terror attacks. This represents an in-
was to accelerate the reduction of maternal, crease of the health work force from 150 to 833
The county’s Maternal Mortality Rate (MMR) newborn and childhood morbidity and mortal- in 2017, including 34 Medical Officers.
for instance stood at 3,795 deaths per 100,000 ity.
live births, which is a significant deviation from In the current financial year (2017/2018), we
the national average of 488 deaths per 100,000 Further, the county made maternal and neo- improved healthcare financing through al-
live births. natal child healthcare top priority areas in the location of over 21% of the total county bud-
health service delivery. We increased the get to health. In addition, in order to double
At the advent of devolution in March 2013, we number of health facilities providing basic Mandera’s human resource for its healthcare
inherited 53 health facilities, out of which only emergency obstetric care (BEMOC) from 18 needs, the County Government has partnered
three were operational, but at only 10% capac- to 70, with all the facilities operating at 100% with the Kenya Medical Training College
ity. In addition, a majority of the 154 healthcare capacity. (KMTC) to train more local health workers.
workers inherited from the national government
were unskilled. The entire county for instance Unfortunately, due to circumstances beyond The implementation of the above strategy is
only had one medical officer. There were no our control, including terrorism, we could not aimed at drastically improving the Reproduc-
ambulance services and the only theatre at attract specialised cadre despite many recruit- tive, Maternal, Newborn, Child and Adoles-
Mandera Hospital was ill-equipped. In fact ment attempts. Further, the county government cence Health (RMNCAH) indicators. We can
Mandera Hospital was in a shocking state of increased the number of facilities that provide now proudly declare that in the last five years
disrepair. comprehensive emergency obstetric care (CE- of devolution, the county has recorded over
MOC) from one to six. By the end of 2017, 63,000 skilled deliveries conducted in our facil-
To address these problems, the inaugural antenatal care attendance had jumped from ities. But we still registered 66 maternal deaths
Mandera County Government developed an 30% to 75%. We also increased the proportion out of the 63,000 deliveries, (0.1%). Our strate-
investment strategy in line with the Millennium of skilled birth attendants from 28% to 70% in gic direction in the next five years is to register
Development Goals to promote gender equal- 2017. In addition, we distributed modern ob- zero maternal deaths.