Blog by Elizabeth Peterson, Soroptimist of the Americas North Atlantic Region Governor, Connecticut Shoreline Club
Building Accountable Maternal Health Systems in Kenya
UN Commission on the Status of Women (CSW70), 16 March 2026; side event on maternal and newborn care systems in Kenya
Over the past decade, the Republic of Kenya has undertaken a transformative effort to build an accountable, locally driven system for maternal and newborn care. At its core, this work reframes maternal health not simply as a clinical issue, but as a matter of justice. One that must be addressed through coordinated governance, community engagement, and sustained investment. By shifting focus to the county level, Kenya has demonstrated that meaningful change often begins within subnational systems, where policies can directly impact the realities of childbirth and care.
A defining feature of this approach has been strengthening accountability and coordination across counties. Localised systems have enabled continuous improvement, with deliberate efforts to identify systemic gaps and respond in real time. The results are striking: in some areas, months now pass without a single maternal death. This progress reflects not only improved medical care, but also the creation of structures that encourage collaboration, transparency, and shared responsibility. Every birth is reviewed, and both deaths and near-misses are carefully analysed, ensuring that each case contributes to learning and prevention. In this way, Kenya has embraced a culture of “making every death count.”
Central to this transformation is the recognition that maternal and newborn outcomes are inseparable. Historically, data systems have treated mothers and babies as distinct categories, obscuring the interconnected nature of their health. Kenya is working to integrate these perspectives, developing surveillance frameworks that track maternal and newborn outcomes together. This shift supports more comprehensive, evidence-based interventions that aim not only to ensure survival, but to promote long-term health and thriving.
The system’s success also stems from its emphasis on practical, often overlooked solutions. Strengthening daily routines in health facilities, conducting regular debriefs, and activating medical teams have all contributed to improved care. Investments in workforce development including training in postpartum care and the proactive management of complications such as hemorrhaging have equipped healthcare workers with critical skills. At the same time, attention to basic needs, such as ensuring access to affordable medicines, blood supplies, functioning ambulances, and sharing specialised personnel across counties has addressed key barriers to timely care.
Notably, the initiative has highlighted how small interventions can yield significant impact. For example, addressing age-related vision loss among healthcare workers by providing eyeglasses has improved their ability to read instruments and instructions, administer medications accurately, and input data effectively. This low-cost solution underscores a broader lesson: system failures are not always complex, but they require careful observation and responsiveness to frontline realities.
Beyond clinical care, Kenya’s model emphasises the social determinants of maternal health. Educating girls and keeping them in school has emerged as the single most powerful driver of economic and health improvement. Efforts to reduce child marriage, expand access to contraception, and prevent adolescent pregnancies are critical components of this work. When girls are supported to delay childbirth until their bodies are fully developed, both maternal and newborn outcomes improve significantly. This reinforces the idea that maternal health justice is deeply connected to gender equality, education, and long-term accountability systems.
Women’s leadership has played a transformative role in advancing these changes. Female leaders have not only driven policy and advocacy efforts but have also opened pathways for the next generation to lead. Their work has been instrumental in demanding government action on urgent issues such as maternal deaths, infant trafficking, and gender-based violence. Complementary services including safe shelters, rescue centers, medical and psychosocial support, and legal assistance further strengthen protections for vulnerable women.
Despite this progress, significant challenges remain. Inequality persists, and the need for stronger bridges between counties and even across borders continues. Implementation bottlenecks, workforce limitations, and gaps in primary healthcare infrastructure must be addressed to sustain momentum. While there is widespread appreciation for dialogue and policy commitments, the emphasis now is on action: proactive prenatal care, early intervention, and universal access to quality services.
Ultimately, Kenya’s experience demonstrates that maternal and newborn health is not a failure of medicine alone, but of systems. Building accountability requires integrating law, policy, healthcare delivery, and community engagement into a cohesive framework. It demands long-term commitment, continuous learning, and a willingness to confront both large-scale inequities and small, solvable problems. By reimagining maternal care through this lens, Kenya offers a powerful example of how health systems can evolve to deliver not just survival, but justice, dignity, and hope for mothers and their children.
