Kenya’s maternal health crisis: Can innovation succeed where systems have failed?

Kenya continues to lose thousands of women to pregnancy- and childbirth-related complications every year, a grim reality health experts say is no longer acceptable, particularly when many of these deaths are preventable.

National figures indicate an estimated 355 maternal deaths for every 100,000 live births. Behind these statistics are women who die from excessive bleeding, undiagnosed medical conditions, delayed referrals and systemic gaps in care — failures that often begin long before labour.

These sobering truths took centre stage at the 50th anniversary conference of the Kenya Obstetrical and Gynaecological Society (KOGS) held in Mombasa. Doctors, researchers, policymakers and health system leaders gathered not merely to commemorate five decades of professional practice, but to confront an urgent national question: does Kenya have the political will, innovation and capacity to end preventable maternal deaths?

The consensus in the room was clear. Kenya understands why mothers are dying. What remains uncertain is whether the country is ready to decisively adopt new tools, invest in frontline capacity and embrace locally driven solutions to reverse the trend.

Over the three-day conference, one issue dominated discussions — postpartum haemorrhage, the excessive bleeding that occurs after childbirth. Health experts identified it as the leading cause of maternal deaths in Kenya, often turning routine deliveries into medical emergencies within minutes.

Delivering the keynote address on behalf of the government, Director General for Health Dr Patrick Amoth acknowledged that maternal deaths persist not because solutions are unknown, but because critical delays continue to undermine care.

According to Dr Amoth, maternal deaths in Kenya are largely driven by what health experts describe as the “three delays”.

The first delay occurs at the household and community level, where women fail to make timely decisions to seek medical care. The second delay happens while trying to reach a health facility, often due to long distances, poor transport networks or lack of emergency referral systems. The third, and often most fatal delay, occurs within health facilities themselves, where the correct clinical decisions are not made in time.

“A mother reaches the facility, but the correct decision is not made,” Dr Amoth said. “This is what we are trying to address by ensuring we build the capacity of the health workforce, put the necessary commodities in place and invest in the infrastructure required to save mothers.”

He revealed that 26 counties account for more than 60 per cent of Kenya’s maternal deaths, prompting the government to launch a rapid response initiative targeting these high-burden regions. The approach prioritises collaboration between national and county governments to ensure availability of essential drugs, adequate staffing and improved governance.

Central to this effort is the strengthening of maternal and perinatal death surveillance and response (MPDSR) systems, which Dr Amoth described as critical for learning from every death and preventing similar tragedies.

While emergency obstetric care dominated the headlines, conference discussions repeatedly returned to a less visible but equally dangerous problem — women’s health issues that go undetected long before pregnancy begins.

According to Prof. Moses Obimbo, general secretary of KOGS and chairman of the Department of Human Anatomy and Medical Physiology at the University of Nairobi, many women suffer for years from heavy or irregular menstrual bleeding without receiving a proper diagnosis.

Some normalise the symptoms. Others make repeated visits to primary healthcare facilities where advanced diagnostic tools are unavailable. In many cases, the underlying condition progresses silently.

“For many women, these problems begin years before pregnancy,” Prof. Obimbo explained. “By the time they conceive, the risks have already been compounded.”

Left undiagnosed, conditions such as uterine fibroids, ovarian cysts and hormonal disorders increase the likelihood of severe anaemia, pregnancy complications and life-threatening bleeding during childbirth.

Dr Kireki Omanwa, president of the Kenya Obstetrical and Gynaecological Society (KOGS), added that the healthcare system’s strain is compounded by a shortage of qualified healthcare workers, especially in the country’s largest referral hospitals.

“A midwife in some of the biggest referral hospitals is managing between 40 and 60 patients at a time,” Dr Kireki said. “She is supposed to take care of the woman delivering, monitor one with complications and take vitals before the doctor arrives.”

He also pointed to the alarming trend of healthcare workers leaving the country in search of better opportunities, exacerbating the already overburdened system.

“They are being poached by high-income countries. While it’s not a bad thing for them, it’s like going to fight a fire in your neighbourhood while there’s a fire in your own house,” Dr Kireki said.

Against this backdrop, researchers at the conference presented what many described as a potential game changer in maternal healthcare: artificial intelligence-supported point-of-care ultrasound (AI-POCUS) for women’s health.

Presented by Prof. Obimbo and a multidisciplinary team of scientists, the research explored how portable ultrasound devices enhanced with artificial intelligence could help frontline health workers detect dangerous conditions earlier, especially in low-resource settings.

Unlike conventional ultrasound machines confined to specialised imaging departments, point-of-care ultrasound (POCUS) devices are portable and can be used at a patient’s bedside or in primary healthcare clinics. This allows nurses and clinical officers — often working without doctors or specialist sonographers — to conduct scans during a woman’s first point of contact with the health system.

“Many of the conditions that kill women are invisible during routine physical examinations,” Prof. Obimbo said. “Yet Kenya has the intellectual capacity to develop solutions using artificial intelligence.”

“What we shouldn’t do is wait to share our data for other people to come and make solutions for us,” he said. “We should generate our own data, use our mathematicians, physicists, bioinformaticians and clinicians to develop AI algorithms that solve our own problems.”

The research findings presented at the conference were drawn from participants across eight countries — Kenya, Sierra Leone, Tanzania, Ghana, Uganda, South Africa, Zambia and Geneva — highlighting both the scale of the problem and the potential for cross-border collaboration.

For clinicians working in overstretched health systems, the promise of AI-supported ultrasound lies in its ability to bridge the gap between limited resources and timely diagnosis. By supporting frontline health workers with decision-making tools, the technology increases the likelihood that women are referred early, before complications escalate into emergencies.

AI-supported ultrasound can help detect uterine fibroids, ovarian cysts, ectopic pregnancies and causes of abnormal uterine bleeding (AUB). If left untreated, these conditions can lead to severe anaemia, pregnancy complications and catastrophic bleeding during childbirth.

As Kenya works toward ending preventable maternal deaths, experts emphasised that innovation must reach the lowest level of care, where most women first interact with the health system.

Technology alone, they cautioned, is not a silver bullet. It must be accompanied by adequate funding, training, reliable referral systems, political commitment and accountability.

The conference concluded with the launch of a new practical handbook titled Basic Obstetric Protocols 2026, designed to translate evidence into action.

The handbook provides clear, evidence-based and practical guidance for healthcare professionals at all levels of service delivery, from community health facilities to referral hospitals. Organisers said the publication is intended to standardise care, reduce delays in clinical decision-making and ultimately save lives.

For many delegates, the handbook symbolised the broader shift called for throughout the conference — moving from discussion to implementation, from knowledge to action and from preventable loss to preventable survival.

As speakers at the golden jubilee conference emphasised, the tools to save mothers already exist. The pressing question now is whether Kenya will act decisively to protect its future generations.