Challenges in Implementing Emergency Obstetric and Neonatal Care (EmONC) in Malindi District, Kenya: A Maternity Health Facility Survey

Emergency obstetric care at district level in Kenya: Implications for policy and local priority setting Elizabeth Echoka - MSc-Public Heath Research Officer- (Maternal and Child Health and Nutrition) Center for Public Health Research Institute, Kenya Medical Research Institute (KEMRI). P.O. Box 20752-00202 Nairobi, Kenya Telephone: +254 722 966 127 Email: lizechokah@yahoo.com Abstract Abstract Reducing the high burden of maternal and neonatal mortality in Kenya depends on identifying and improving services that are critical to lives of women and newborns. The knowledge on “what and where’’ is therefore the first and critical step to improving equitable access to services and to strengthening the health system. The paper seeks to contribute to this knowledge by examining the availability of emergency obstetric care services at district level in Kenya using data from a maternity health facility survey. The findings indicated that emergency obstetric care facilities were inadequate (3 versus 4 facilities for 400,514 populations). Rural–urban differences in distribution of facilities were observed. The least performed signal functions were administration of parenteral antibiotics (10.7%), parenteral anticonvulsants (14.3%) and neonatal resuscitation (39.3%). Assisted delivery was not performed in any facility. A shortage of nurse-midwives at all levels was observed. The gaps in availability of life saving services revealed in this study may point to the health system conditions contributing to lack of improvements in maternal and neonatal survival in Kenya. As such, the findings bear considerable implications for policy and local priority setting. The authors declare that they have no conflict of interests