By The PPH Foundation
Kenya continues to face a critical challenge in preventing maternal deaths from postpartum haemorrhage, the leading cause of avoidable maternal fatalities in the country. Each year, approximately 5,000 mothers lose their lives during childbirth, many due to delays in care that could be prevented with timely, skilled clinical intervention. Yet, shortages of midwives and uneven distribution across counties leave health facilities ill-equipped to respond, particularly in rural and underserved areas. Addressing these workforce gaps is essential to ensure every mother receives the care she needs when she needs it.
Kenya’s health workforce density is well below international recommendations. According to a 2025 health labour market analysis, the country produces about 8,200 health workers annually and employs around 190,000 health professionals across major cadres, including nurses, midwives, doctors, and specialists. However, the distribution and concentration of skilled personnel remain uneven, with rural areas disproportionately underserved. While some counties have stronger staffing levels, many rural regions face acute workforce shortages that directly impact maternal care delivery.
The World Health Organization recommends a minimum health workforce density of 23 skilled professionals per 10,000 population to achieve basic health coverage, yet Kenya’s density stood at about 14.3 per 10,000. Only a few urban counties meet this threshold, while others fall significantly short, indicating long‑standing human resource gaps across the health sector.
The 2025 State of the World’s Midwifery report estimated that supporting midwives more broadly could avert up to 67 percent of maternal deaths worldwide, underscoring the life‑saving impact of adequate midwifery coverage. Despite this, Kenya faces its own challenges with midwife availability. In addition to workforce density gaps, registered nurses and midwives are concentrated in higher‑level referral facilities, leaving primary health facilities and rural clinics under‑staffed.
Dr Eunice Atsali, a midwife and Co‑Lead of the End PPH Initiative, explains that workforce shortages translate directly into delayed recognition and response to PPH: “When midwives and skilled birth attendants are unavailable or overworked, critical signs can be missed and opportunities for lifesaving care are lost.” Strengthening staffing norms, expanding training capacity, and deploying skilled professionals more equitably are essential to improving outcomes.
Investment in standardized midwifery education and post‑qualification training is also critical. Studies have shown that midwives, when trained and supported, can provide up to 87 percent of essential maternal and newborn care. However, systemic issues such as limited professional development, poor retention in rural areas, and weak career support undermine this potential.
Ultimately, closing the workforce gap is not just a numbers game but a strategic imperative. Equipping health facilities with trained, motivated, and well‑distributed midwives and nurses will be pivotal in reducing PPH deaths, strengthening Kenya’s maternal health system, and advancing national and global health goals.
Sources:
• Kenya’s 2023 Health Labour Market Analysis, WHO Regional Office for Africa
• State of the World’s Midwifery Report, UNFPA, 2025
• PMNCH/WHO maternal mortality analysis for Kenya, 2025
• Pan African Medical Journal, survey on nurse‑midwife care quality, 2023
• KDHS trends on maternal care access and skilled birth attendance
<a href="https://www.freepik.com/free-photo/obstetrics-medical-team-delivering-baby-woman_18049238.htm">Image by DC Studio on Freepik</a>