A recently published report on Partnerships for Maternal Newborn and Child Health and the Countdown to 2015     indicates that Kenya is currently losing more than 7,000 women annually, a rate of 21 daily, to pregnancy related complications. However, a report by the the  Human Rights Watch shows that a greater focus on accountability in health facilities offering maternal health care, could reverse this trend in Kenya and indeed in the whole of Africa. Like Kenya, South Africa is unlikely to meet her commitment under the United Nations Millennium Development Goals to reduce maternal deaths (MDG 5) by 75 percent between 1990 and 2015. The UN estimates that 4,500 women die each year in South Africa due to preventable and treatable pregnancy related complications.

The Human Rights Watch in South Africa published a report in August 2011 titled “Stop Making Excuses: Accountability for Maternal Health Care in South Africa,” which examines the shortcomings in the tools used by health authorities to identify and correct health system failures that contribute to poor maternal health. The report documents maternity care failures that include abuse of maternity patients by health workers and substandard care, putting women and their newborns at high risk of death or injury based on a field research between August 2010 and April 2011 with maternity patients, families, community caregivers, health and human rights experts, health workers, government officials, and representatives of donor and international agencies.

A key finding of the research was that lack of oversight and accountability for recurrent problems in the health system and abuses committed by health personnel contributes to South Africa’s substandard maternity care. According to the authors of the report, “The government admits that it has a big problem on its hands and wants to do better; but for all South Africa’s good intentions, policies and strategies on paper won’t save women’s lives without strong accountability systems to make sure policies are carried out.”

The huge gap that exists between policy and implementation is not a problem that is peculiar to South Africa. In Kenya, major gaps exist in the areas of knowledge, policy, funding and implementation. In upholding the five principles of the Paris Declaration (Ownership, alignment, harmonization, managing for results and mutual accountability), the  German Development Cooperation through the GIZ Health Sector Programme (HSP) is currently investing in building management skills of health managers in the GIZ focus districts by adopting a two pronged approach that covers mentorship and Management Basics for Essential Health (MBEH).

In the previous year, this approach went a long way in equipping health managers with management skills and as a result, there was marked improvement in customer care which in turn resulted in improved client satisfaction.For example, In Gucha district, there was an increase in hospital deliveries from an average of 350 births a month in 2009 to 450 a month in November 2010. Vihiga district recorded increased uptake of long term methods of family planning; the number of implants inserted in October 2010 was about 60 up from about 18 in July 2010.Better staff attitudes to patients was noted by District Health Management Teams (DHMTs) in across all the four GIZ focal districts i.e Bondo, Vihiga, Butere and Gucha.

Efforts towards scaling up the MBEH program are currently underway. It is evident that GIZ efforts are impacting on improving service delivery especially in the area of reproductive health and will go a long way in helping Kenya make great strides towards achievement of MDG 5 (Improving maternal mortality by the year 2015).

The link to the full report is here below:

http://www.hrw.org/sites/default/files/reports/sawrd0811webwcover.pdf