Penina Zawadi, a 29-year-old Kenyan mother, died on June 23 after experiencing severe postpartum bleeding. Her death, which occurred after a prolonged period awaiting transfer and further medical intervention, underscores the critical weaknesses in healthcare services in Kenya's Kilifi County.
Zawadi's case is part of a larger series examining maternal mortality in sub-Saharan Africa, a region accounting for 70% of global maternal deaths annually. In Kilifi County, located along the coast and known for its tourism, maternal mortality rates are significantly higher than the national average. According to 2022 government data, the county recorded 532 maternal deaths per 100,000 live births, compared to the national average of 355.
Causes of Maternal Mortality
Reproductive rights organizations attribute most maternal deaths to severe bleeding, obstructed labor, high blood pressure-related conditions like preeclampsia, and infections from unsafe abortions. Shortages of essential medical equipment, inadequate transportation to advanced care facilities, and a lack of accessible information for pregnant women and their families exacerbate these issues.
Despite the challenges, the Kilifi County government stated in June that it had recorded 81 maternal deaths in the past year and a half, which it described as progress. The government pointed to efforts to increase the number of healthcare facilities to improve access to services. However, some local clinics reportedly remain basic outposts with limited medical supplies. Recent funding cuts from international donors have further complicated the situation for vulnerable populations.
Personal Tragedies and Systemic Failures
Zawadi's family reported that she bled heavily for hours at Malindi Hospital before being referred to Kilifi County Referral Hospital, a journey of about an hour on a difficult road. After undergoing a second surgery to remove her uterus, she never regained consciousness. Her grandmother recalled the excessive bleeding, stating, "She was bleeding so much, you would think it was water gushing out."
Another woman, Halima Ramadhan, died in March while delivering twins. Her family also reported a lack of clear information regarding her condition and cause of death. They were asked to purchase medication from a private pharmacy, and only after the Associated Press reviewed her discharge summary, which cited heart failure following high blood pressure, did the family learn the cause of death. The Kilifi County government did not respond to specific questions about Zawadi's and Ramadhan's deaths or the local maternal mortality rate.
Community health workers, like Chadi Karisa who runs a health center in Kilifi, witness these struggles firsthand. He noted issues with underpaid and overworked health staff, communication gaps with patients, and instances where pregnant women delay seeking care due to a lack of information. Local NGOs, such as the Youth Voices and Action Initiative, are working to educate women and girls on maternal health through community forums and podcasts, emphasizing the importance of engaging trusted community health promoters.