By The PPH Foundation
Kenya’s fight against postpartum haemorrhage now hinges on whether the health system can translate policy into dependable delivery. National guidelines are clear about risk assessment, active management of labour, rapid response and timely access to blood, yet too many facilities struggle with referral delays, stock-outs, poor documentation and uneven skills. The result is a fatal mismatch between intention and execution, where system failures overwhelm clinical knowledge.
Postpartum haemorrhage exposes these gaps without mercy. A woman experiencing heavy bleeding needs a chain of readiness; a trained nurse, an emergency trolley with uterotonics, calibrated drapes, a working ambulance, a blood bank and a referral centre capable of critical care. If any link breaks, survival drops. This is why strengthening health systems is now understood as a life-saving agenda, not an administrative task.
Across counties, signs of structural reform are emerging. Some hospitals are adopting maternity dashboards to monitor haemorrhage cases in real time; others are prioritizing training in emergency obstetric care so that teams work under standard protocols. County governments such as Kakamega and Nakuru are reorganizing ambulance dispatch through central command models to shorten time to treatment. These improvements suggest that maternal survival is becoming a governance issue measured against performance, not goodwill.
Professor Moses Obimbo, the End Postpartum Haemorrhage Initiative Project Lead, a project at the PPH Foundation in collaboration with the University of Nairobi, The Kenya Obstetrical and Gynaecological society, and the Midwives Association of Kenya, stresses that system reliability is the foundation of clinical success. According to him, Kenya does not suffer from knowledge scarcity, it suffers from structural inconsistency. If a health worker knows what to do but lacks blood, lacks equipment, or cannot secure referral, mothers continue dying unnecessarily.
Strengthening systems also requires transparency. Counties must count maternal deaths, review what went wrong and record postpartum haemorrhage trends. Procurement needs to be predictable. Calibrated drapes, oxytocin, tranexamic acid, IV fluids, surgical capacity and blood must be universally accessible. When these basics turn from aspiration into standard practice, postpartum haemorrhage shifts from inevitable tragedy to preventable emergency.
The next frontier is reliability; a mother in a rural dispensary should have the same emergency pathway as a mother in a referral hospital. When systems work, women survive.
<a href="https://www.freepik.com/free-vector/pregnant-woman-obstetric-ultrasound-cartoon-pregnancy-medical-examination_2238443.htm">Image by vectorpouch on Freepik</a>
Sources
• WHO postpartum haemorrhage care guidance update
• RMNCAH policy priorities in Kenya