By The PPH Foundation

Preventable maternal deaths remain a pressing challenge in Kenya, with postpartum haemorrhage accounting for a significant portion of fatalities. Ensuring accountability at all levels; from policy and management to frontline service delivery, is critical to improving maternal survival. Accountability mechanisms encompass monitoring performance, enforcing standards, reporting outcomes, and fostering transparency in the use of resources.

According to the 2022 Kenya Demographic and Health Survey, maternal mortality in Kenya stands at 342 deaths per 100,000 live births, with notable disparities between urban and rural counties. Weak accountability in procurement, staffing, and emergency response often contributes to preventable deaths. For instance, stock-outs of uterotonics and delayed referrals have been linked to lapses in reporting, supervision, and follow-up.

Prof Ann Kihara, Co-Lead of the End PPH Initiative, notes that accountability is as much about culture as it is about policy: “We must ensure that every health system actor, from administrators to clinicians, is answerable for maternal outcomes. Transparent reporting, timely audits, and evidence-based decision-making save lives.”

Efforts to strengthen accountability include data dashboards for real-time monitoring of maternal health indicators, regular audits of health facility readiness, and performance reviews for frontline staff. The End PPH Initiative supports counties to adopt these measures, emphasizing that accountability also involves communities, civil society, and media in tracking health outcomes.

Evidence shows that health systems with strong accountability mechanisms achieve higher rates of skilled birth attendance, prompt emergency response, and lower maternal mortality. By embedding accountability into governance structures, Kenya can reduce PPH deaths, improve service delivery, and foster public trust in the health system.

Sources:
• Kenya Demographic and Health Survey 2022, KNBS
• WHO, “Strategies to Improve Maternal Health Accountability,” 2023
• PMNCH, Accountability in Maternal Health, 2022
• End PPH Initiative, Maternal Health Data Dashboard, 2025
• African Journal of Reproductive Health, Health System Accountability Studies, 2023

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