Tracking Maternal and Newborn Health Interventions in Kenya
Maternal and newborn health remains a significant public health concern globally.
According to the Kenya Demographic and Health Survey, the country’s maternal mortality rate stood at 488 deaths for every 100,000 live births in 2008/091 and Kenya is unlikely to achieve its aim of reducing the rate to 147 per 100,000 live births this year. Moreover, while infant mortality rates have progressively decreased in the last decade, they remain unacceptably high at 39 deaths per 1,000 live births.2
Ending preventable child and maternal deaths is a priority for the Government of Kenya and the United States Agency for International Development (USAID). To address the challenge of high maternal death, it was necessary to develop a tool for decision makers to track the magnitude of, and factors contributing to, maternal and child deaths and also to improve service delivery and uptake and accuracy in reporting data.
Consequently, in May 2014 the Ministry of Health (MOH), through the Division of Health Informatics and M&E and in collaboration with development partners, including critical support from the USAID-funded MEASURE Evaluation PIMA (MEval-PIMA), started developing a reproductive, maternal, newborn, and child health (RMNCH) Scorecard for the country. The result of this work is a quarterly Scorecard comprising 27 national- and county-level indicators across six categories that span the care continuum and are: pregnancy and newborn, early childhood, late childhood, adulthood, health systems, and the community.
According to Dr. David Soti, head of the Division of Health Informatics and M&E, “The RMNCH Scorecard is meant to help not only managers but also the public to know the state of health in their counties.”
The Division of Health Informatics and M&E, in conjunction with UNICEF and MEval-PIMA, subsequently embarked on the Scorecard’s roll out through three-day orientation workshops. This process targeted the Directors of Health, Reproductive Health Coordinators, and Health Records Information Officers, with support from county-level implementing partners. All 47 counties were grouped into nine clusters and taken through the workshops, which covered the background to the Scorecard, the development and computation of its indicators, and its utility as a management, advocacy, and accountability tool.
Feedback from the workshops, and reviews using the Scorecard, is promising. One of the trainees, Dr. Gerishon Abakalwa, the Baringo County Health Director, described the training as an enlightening experience:
“Today I have learnt there is a difference between using the Scorecard for information purposes versus using it as a planning and management tool. The Scorecard can be used to identify gaps and inform decisions on interventions to address them. As a manager, I plan to use the Scorecard for budgeting and the allocation of resources with the County Assembly and its partners.”
Some of the immediate follow-on actions for the county teams from the workshops were to integrate the Scorecard into routine review cycles, identify their weakest areas, best practices in other counties they could implement, and determine any other impacting factors, such as geographical challenges and health worker staffing levels.
The success in rolling out the RMNCH Scorecard nationally, and commitments to integrate it into routine performance review cycles, is promising and provides a necessary platform to support county teams and their partners to utilize it optimally as a decision-making and accountability tool.
Click here for more information on MEval-PIMA support to Kenya’s Division of Family Health and Reproductive and Maternal Health Services Unit.
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1. Kenya National Bureau of Statistics (KNBS) and ICF Macro. Kenya Demographic and Health Survey 2008-09. Calverton, Maryland: KNBS and ICF Macro, 2010.
2. Kenya National Bureau of Statistics (KNBS) and ICF Macro. Kenya Demographic and Health Survey 2014: Key Indicators. Calverton, Maryland: KNBS and ICF Macro, 2015.