The Role of KNH/UON in Accelerating the Achievement of MDGs 5 and 4

1. The Role of KNH/UON in Accelerating the Achievement of MDGs 5 and 4 Dr. Gathari Ndirangu Reproductive Health MNCH Symposium 10 January 2013 1

2. MDG 5 in Kenya • MDG 5 is off target • MMR target: 147/100,000 live births by 2015 • Universal access to RH • Current MMR: 488/100,000 live births*, up from 414 in 2003** • Newborn part of MDG 4 has stagnated • Neonatal mortality rate 31/1000 live births* • 60% of IMR • Commendable progress in the other MDGs (especially 1, 2, 3) *KDHS 2008-09 **KDHS 2003

3. Socioeconomic Determinants of Maternal Mortality • Illiteracy, poverty and poor women empowerment • Pregnancy too soon, too frequent, too many • Inadequate access to RH/MNH/FP services • Delivery under unskilled care • Limited accountability at all levels

4. Policy Environment

5. KNH’s Strengths to Accelerate Achievement of MDG5 • Strategic objectives to fulfil national mandate, vision and mission • To improve quality specialized reproductive healthcare • To reduce maternal and perinatal morbidity and mortality • To enhance training and research • To contribute to national RH planning and policy formulation • To strengthen institutional linkages and collaboration • To contribute to corporate social responsibility and improve on hospital image

6. MNH Strategic Objectives • Reduce maternal and perinatal morbidity/mortality • Service provision from primary to tertiary care • PMTCT program • Training and research • Graduate and undergraduate levels, paramedical • Vibrant and respected research community • Translation of research into policy and practice • Contribute to national RH planning and policy formulation • Institutional linkages and collaboration, including PPP

7. Challenges • Heavy client load (outstrips capacity) • Non-booked ANC clients (~60%) • Late referrals • High MMR • 1223/100,000 LB (Jan-Nov 2012) • High NMR 116/1000 LB (Jan-Dec 2012) • Prematurity • NN Sepsis • Term RDS • Birth asphyxia

8. KNH’s Opportunities for Improving MNH Indicators • Highly trained workforce • Favorable policy environment • National referral hospital • Devolved governance • Strengthen lower tier health care facilities • Effective knowledge and skill transfer • Mentorship • Timely and supportive feedback to referring HCFs • Satellite health care facilities • Modern technology

9. KNH’s Opportunities for Improving MNH Indicators • Proactively creating modalities to realize full potential in MNH services • Advocacy • Participation in national RH planning including MPDSR • Training • Research • Collaboration including PPP • Provision of full range of FP services (LAPM) • Timely reporting to the national HMIS for national planning

10. Threats • Political interference and uncertainty • Poverty • Inadequate financial resources • Commodity insecurity/inadequate equipment • Increased litigation • Industrial strife • Inadequate health workforce

11. National Vision 2030 MNH target • MMR- 113/100,000 LB (77% reduction) • From 1223 to 281/100,000 LB • NMR- 13/1000 LB (59% reduction) • From 116 to 47/1000 LB • Together, we are up to the task!