Kenya has made considerable progress in the attainment of Millenium Development Goals, or MDG's by the introduction of Kenya Vision 2030. However, progress towards attaining the overall health goals show mixed results and the country is not on track to achieve the commitments relating to health-related MDG's. Improved access and equity in the availability of essential health care is still behind especially in rural areas and as a result, the population in rural areas are not effectively able to participate in the development of the nation. According to the Kenya Demographic and Health Survey, Kenya's maternal mortality rate in 2014 was 488 maternal deaths for every 100,000 live births1. This means Kenya is ranked 28th worst on this count. Additionally,the mortality rate for children under the age of 5 is reported at 71 per 1000 births2, making it ranked 35th worst. Improving access to reproductive health has remained a huge challenge in Baringo county and in the entire nation.
In particular, sexual reproductive health (SRH) is needed in this area because:
- Marginalized women lack empowerment and are poorly educated, which reduces their access to health services.
- There are low levels of infrastructure and many negative cultural health practices such as female genital circumcision (FGC).
- Many women and teenage girls are denied decision-making roles regarding their health and family size.
- The PRB indicates that unmet need for family planning in Kenya is 25% overall, but much higher in rural areas. Our experience of Dandelion’s recent free mobile clinics shows that there is a high demand for family planning but the MoH services do not provide family planning for free (other than condoms and the pill).
- The average distance to the nearest health centre in Baringo is 18 km which means most poor people do not access SRH services.
- According to KNBS 2012, the ratio of doctor to patient in Baringo county is 1:57,381.
- The mortality rate of children under 5 years of age is estimated at 71 deaths per 1000 live births and the maternal mortality rate stands at 488 per 100,000 population.
These factors combine to perpetuate poverty through lack of time for productive work due to close spacing and large numbers of children. The Baringo County fact sheet indicates that poverty factors include a) long distances to health centres which lack equipment and staff, b) lack of information and empowerment programs in rural areas, c) very low male participation in SRH, even though men are the sole decision makers in most households, d) stigma and discrimination against PLWD and PLWHA, e) low training and experience by CHWs to deliver health talks and services f) inadequate data collection making allocation of resources and planning challenging g) very low numbers of female students transitioning to tertiary levels of education (which is blamed on negative cultural practices e.g. FGC, early marriages, early pregnancies and low levels of girl child education), h) lack of enough NGOs willing to work in remote areas and lack of capacity by local CBOs to offer support due to poor infrastructure and lack of knowhow, i) forced and unskilled abortions due to poverty, j) lack of basic hygiene practices e.g. mosquito nets, access to clean water.
Target groups: Due to these challenges and weak achievement of health MDGs in Baringo County, Dandelion Africa's target groups are a) women and girls of reproductive health because they are mainly affected by the burden of raising a large family and cultural practices such as FGC b) children who need immunization and deworming c) teenage girls and boys who need SRH education and services d) PLWD who cannot access health centres due to poor infrastructure, stigma and discrimination e) men from the communities who are not sensitized on their role in SRHR.
- Kenya National Bureau of Statistics (KNBS) and ICF Macro. Kenya Demographic and Health Survey 2008-09. Calverton, Maryland: KNBS and ICF Macro, 2010.
- Kenya National Bureau of Statistics (KNBS) and ICF Macro. Kenya Demographic and Health Survey 2014: Key Indicators. Calverton, Maryland: KNBS and ICF Macro, 2015.