By The PPH Foundation
Kenya’s frontline health workers continue to play a defining role in saving mothers’ lives as the country strengthens its collective response to postpartum haemorrhage. Under the End PPH Initiative, a project of the PPH Foundation in collaboration with the University of Nairobi, the Kenya Obstetrical and Gynaecological Society and the Midwives Association of Kenya, counties are scaling up training, improving readiness and enhancing coordination across all levels of care.
Obstetricians and gynaecologists lead the management of severe and complex PPH cases. Their role includes performing advanced procedures such as uterine balloon tamponade, surgical control of bleeding and managing clotting complications. Prof Moses Obimbo explains that specialists also drive facility preparedness by guiding protocols, supervising emergency drills, reviewing outcomes and ensuring that essential equipment and theatre teams are on standby at all times. Their leadership ensures that once bleeding begins, no time is wasted.
Clinicians and medical officers form a vital middle layer in the response chain. Their training focuses on early assessment, accurate administration of uterotonics, shock management, fluid resuscitation and stabilisation before referral. Regular simulation sessions have helped clinicians internalise rapid decision-making, triage skills and adherence to PPH checklists, improving both speed and accuracy in emergency response. Their timely escalation of care often determines whether a case progresses to severe bleeding.
Midwives remain the first responders during childbirth and are central to early detection. Their expanded training includes identifying risk factors during labour, recognising early warning signs, performing active management of the third stage of labour, initiating first-line interventions and activating emergency pathways without delay. Dr Eunice Atsali, a Co-Lead at the End PPH Initiative notes that mentorship and county-level drills have equipped midwives with stronger confidence and preparedness, enabling them to spot PPH sooner and act faster during critical minutes.
Community health workers extend preparedness into households and communities. They identify high-risk mothers, link them to skilled birth attendants, support early referrals and educate families on danger signs. Their role in reducing delays at home and ensuring timely facility access is crucial, especially in rural and remote areas.
Experts agree that training alone is insufficient without teamwork and system readiness. Counties have introduced joint drills linking midwives, clinicians, specialists, ambulance services and blood banks to strengthen communication under pressure. Facilities are stocking ready-to-use PPH emergency kits, refining referral pathways and improving coordination with roaming blood services to reduce delays in accessing lifesaving blood.
With enhanced training, stronger preparedness and seamless teamwork across cadres, health workers remain Kenya’s most powerful defence against preventable maternal deaths.
Sources
WHO PPH Care Pathway 2023
FIGO Maternal Health Guidelines 2024
PPH Foundation records
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