NAIROBI — The maternity ward inside the Nairobi Women’s Hospital in Kenya is unusually quiet. A room that houses two new mothers today usually exceeds capacity with six, but the delivery room is empty, and only a handful of family members are visiting those babies who have recently made their debuts. While it’s like this, the workload for nurses and doctors is manageable, but Joyce Muraguri, head of the ward, explains that isn’t usually the case.

“The biggest challenge that I face mostly is when we do not have enough staff. When you have to deal with many mothers at the same time, you are not able to give the quality services that you are required to,” she said.

Normally the nurses are rushing from mother to mother monitoring the progression of labor and checking on the newborns. It’s easy for things to get hectic, especially given the staff shortages the country faces, said Muraguri.

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Joyce Muraguri, head of maternity ward at Nairobi Women's Hospital, filling out patient information at her desk.

The World Health Organization recommends having 23 doctors, nurses, and midwives per 10,000 people, but Kenya averages 13. The lack of staff is a contributing factor to the 6,000-8,000 mothers who die in childbirth in the country each year; when resources are stretched, the quality of care wanes, and the likelihood of complications — such as postpartum hemorrhage, sepsis, and eclampsia — rises. As per the Sustainable Development Goals, the aim is to reduce the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births.

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SDG goal

SDG Goal 3.1. – The global maternal mortality ratio should be reduced to less than 70 per 100,000 by 2030

Maternal mortality rates in Kenya (per 100,000 live births)
Source: World Bank

Since the government of Kenya made maternal care free in 2013, resources have been further under strain and systems overburdened, said Ruben Vellenga, Sustainable Development Goals partnership specialist at the United Nations resident coordinator's office in Kenya.

Previously, a lack of skilled care was a contributing factor to the number of maternal deaths, but the challenges have changed, said Vellenga.

"More women are actually dying at the center because they get there, but the quality can’t be kept up so they can’t get the right attention or services,” he said.

Ruben Vellenga, Sustainable Development Goals partnership specialist at the United Nations resident coordinator's office in Kenya.

The eradication of cost has increased the amount of women coming through the doors, but the staffing and quality of care has yet to match the demand for maternal care.