ArticleBMC pregnancy and childbirth2025
Trends in maternal mortality and stillbirths by county in health facility data, Kenya, 2011-2022.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Letter to the editor: Perinatal mortality in eastern Africa: A systematic review and meta-analysis.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Measurement of maternal mortality, United Republic of Tanzania.Bulletin of the World Health Organization · 2026Article
- A setback for Sustainable Development Goal 3.1: Documenting the coronavirus disease 2019 pandemic's impact on maternal mortality through a National Confidential Enquiry in South Africa.African journal of primary health care & family medicine · 2026Article
- How many women in East Africa suffer from iatrogenic fistula after caesarean birth?BMJ global health · 2026Article
- Time to first antenatal care visit and its predictors among women in Kenya: Weibull gamma shared frailty model (based on the recent 2022 KDHS data).BMC pregnancy and childbirth · 2025Article
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Abstract
backgroundReports on maternal deaths and stillbirths in health facilities are a critical but underutilized source of information to monitor the quality of care. In addition, with increasing coverage of deliveries by health facilities, such data can improve population estimates of maternal mortality and stillbirth rates. Data quality concerns, however, have often deterred use of facility data. This study aims to assess subnational trends in institutional mortality and examine its utility for improving population-based estimates of mortality.
methodsData from the routine monthly reporting system of the Ministry of Health in Kenya were used to assess levels and trends in maternal mortality and stillbirth rates in 47 counties from 2011 to 2022. Data quality was assessed using multiple methods, including consistency of annual reporting of live births, stillbirths and maternal deaths by counties, plausibility of the ratio of reported stillbirths to maternal death, the county institutional mortality in comparison to delivery coverage, socioeconomic development and health system characteristics. The consistency between institutional and population estimates of mortality was assessed using different scenarios.
resultsInstitutional live birth coverage increased from 64.0% in 2014 to 87.8% in 2022, ranging from 49 to 99% in counties. Kenya and 39 of its 47 counties experienced a decline in institutional maternal mortality ratio and stillbirth rate during the study period 2011-2022. The national institutional maternal mortality decline stagnated from 2018 and was 99 maternal deaths per 100,000 live births in 2022. Consistency of reported data by county was good over time but several indicators suggest that maternal death reporting was incomplete and more so in less-developed counties. Estimates of the population maternal mortality ratio, derived from the facility data, were much lower than global estimates or census results, while the stillbirth rates were consistent.
conclusionThe health facility data on maternal death and stillbirths are an important data source for monitoring national and subnational institutional maternal mortality and stillbirth rates and can also inform population estimates. Systematic sustained assessment of reporting completeness will be critical to achieve the full potential of facility data-derived mortality monitoring.
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