Thousands of expectant mothers and newborns continue to die from childbirth-related complications amid a Sh193 billion funding shortfall that has left Kenya’s maternal and newborn health system without essential drugs, sufficient staff, and critical emergency services when complications occur.
This comes four years before Kenya's deadline to meet Sustainable Development Goals 3.1 and 3.2, which require the country to reduce maternal deaths from the current 355 per 100,000 live births to no more than 70, and cut newborn deaths from 15 to no more than 12 per 1,000 live births. At the current pace, health officials say, neither target will be met.
At 355 maternal deaths per 100,000 live births and approximately 1.8 million pregnancies per year, an estimated 6,000 Kenyan women die from pregnancy and childbirth-related causes every year. At the SDG target of 70 per 100,000, that number would fall to approximately 1,260.
"These are not just numbers. Every loss is a family devastated and a future cut short," said Edward Serem, head of the Reproductive Maternal, Newborn, Child and Newborn Health Division at the Ministry of Health.
The Sh192.9 billion financing gap is attributed to three pressures that have converged on Kenya's health system at the same time. The first is the inadequate allocation of domestic government resources for maternal and newborn health, the shrinking external donor support, as international funding programmes that sustained clinical training, drug procurement, and community health outreach is ending.
The third is the disruption caused by the transition from the old National Hospital Insurance Fund (NHIF) to the new Social Health Authority (SHA), during which legacy financing ended before its replacement was fully operational.
As a result, SHA has been slow to reimburse public health facilities for services already delivered, leaving hospitals and health centres drawing from their own reserves to cover drug procurement, utility bills, and staff salaries while waiting to be paid.
The Emergency, Chronic and Critical Care Fund, the specific SHA fund covering emergency obstetric and newborn care, received a Sh8 billion allocation in the current financial year.
That represents 7.5 percent of SHA’s total budget for a fund that is supposed to cover every woman and newborn in Kenya facing a life-threatening complication.
However, health officials say the allocation is inadequate for the case load the fund was designed to meet.
Similarly, withdrawal of donor financing is adding to the pressure, as programmes that once supported maternal and newborn health work at the community level are contracting.
A fall in facility delivery rates in 2023 and 2024, from an 89 percent high, was directly attributed to the disruption caused by the donor exit.
“Drastic reductions in donor aid risk reversing gains," officials warned at the 2026 International Maternal and Newborn Health Conference (IMNHC).
The Ministry of Health has acknowledged what it calls the Quality-Access Paradox—the fact that despite increasing facility-based deliveries from 39 percent two decades ago to 88 percent today, maternal and newborn mortality has barely moved. More women are arriving at centres, but those facilities cannot consistently deliver safe care.
"Coverage without quality will not save lives. Where a baby is born should never determine whether they live or die,” said Loise Nyanjau, who leads maternal health programming at the ministry.
"Access without quality is not enough," added Janette Karimi, head of the Reproductive Maternal Health. "Every contact with the health system must be safe, effective, and respectful."
The most immediate consequence of the funding gap is the shortage of essential drugs. Kenya's Medical Supplies Authority (Kemsa) is currently operating at below a 75 percent order fill rate for essential medicines, which means at least one in four orders placed by health facilities goes unfulfilled.
Among the medicines failing to reach facilities are Oxytocin, an injection that prevents postpartum haemorrhage, and Magnesium Sulphate, which controls seizures that kill women with eclampsia.
Postpartum haemorrhage is the single leading cause of maternal death in Kenya.
Both drugs are listed on Kenya's Essential Medicines register and cost very little, but they are absent due to financing failure.
As a result, postpartum haemorrhage is being correctly managed in only 40 percent of cases nationally.
The drug shortage is also costing newborns their lives. Birth asphyxia, the failure of a newborn to breathe at delivery, is the leading cause of neonatal death in Kenya and is being correctly managed in only 36 percent of cases nationally.
Basic equipment, including CPAP (continuous positive airway pressure) machines for breathing support, phototherapy units for jaundice, and resuscitators, is absent from many newborn units across the country, according to data from the 2023 Census.
Kenya records 17,901 neonatal deaths every year, equivalent to 49 newborns dying every single day.
"Newborn survival is not just about hospitals. It is about systems. Every delay costs a life,” said Juliet Omwoha, head of Newborn and Child Health at the ministry.
Beyond the drugs, the gap is grounding the emergency transport system that is supposed to save mothers and newborns when complications arise.
Kenya's health facilities are structured across six tiers, with lower-level facilities expected to transfer patients with complications to hospitals equipped for surgery and blood transfusion. But no coordinated national ambulance system reliably covers that transfer.
The Ministry of Health's maternal death reviews identify what clinicians call the second delay—the time lost between deciding a woman needs emergency care and getting her to a facility that can provide it, as a primary driver of preventable maternal and newborn deaths.
Moreover, Comprehensive Emergency Obstetric Care is not consistently available even at the Level 4 and 5 hospitals that are classified to provide it. Of Kenya's 47 counties, only two have reached the SDG newborn mortality target. Some 27 remain in the high-risk category.
The workforce crisis is deepening the problem further. Under Kenya's devolved governance structure, 47 county governments are each responsible for hiring and retaining health workers within their borders.
However, 74 percent of those regions currently have fewer than 70 percent of the required medical personnel in their health facilities.
The government has outlined four interventions it says are needed to close the gap. They include a review of the SHA health benefits package to better cover maternal and newborn care needs, a push to bring health facilities into compliance with Emergency Obstetric and Newborn Care standards, stronger team-based models of care across antenatal visits, delivery, and postpartum follow-up, and the digitisation of the Maternal and Perinatal Death Surveillance and Response system so that deaths can be reviewed and acted on in real time.
However, officials acknowledged that each of these interventions requires financing that has not yet been secured.
"No woman should die while giving life, and every newborn must have the chance not only to survive, but to thrive," said Health Cabinet Secretary Aden Duale at the opening of the conference on Monday.
