Awe Oluwafunmilola Deborah, Kipruto Hillarry, Awe Olawale, Chukwudum Queensley C
Department of Medical Statistics (UNITID), University of Nairobi, Kenya.
Senior Statistician, World Health Organization, Nairobi, Kenya.
East Afr Health Res J. 2023;7(2):166-174. doi: 10.24248/eahrj.v7i2.728. Epub 2023 Nov 30.
Kenya has taken significant steps to improve Reproductive Maternal Neonatal Child Adolescent Health (RMNCAH) services, with a vision to prevent preventable deaths of women and newborns. This study seeks to fill a crucial gap in understanding the dynamics of maternal mortality in Kenya, post-devolution.
The study spans all the 47 counties of the Republic of Kenya, using county as the unit of analysis. Maternal Mortality Ratio (MMR) data was extracted from the District Health Information Software (DHIS), which was created to evaluate the level of progress in coverage of RMHCAH service in Kenya. Changes in the MMR Indicator was modelled over time using Repeated measures one-way ANOVA in the 47 counties in Kenya.
A descriptive study uncovered an average reduction in the MMR, which decreased from approximately 170 to 130 per 100,000 live births between 2012 and 2018. There was a steady decrease in MMR in Garisa, Mombasa, Busia, Elgeyo, Samburu and Uasin. Tables and figures were used to visualise findings.
Our findings revealed that although there has been continuous improvement of relative equity over the last quarter-century in all the 47 counties in Kenya, uneven coverage remains within each county. This lack of equity differs from one county to another. There was a significant difference within each year and among the years, and pairwise comparison revealed a significant difference in the MMR between 2012 and all the years except 2016 and 2017.
肯尼亚已采取重大举措改善生殖、孕产妇、新生儿、儿童和青少年健康（RMNCAH）服务，目标是预防妇女和新生儿的可预防死亡。本研究旨在填补肯尼亚权力下放后理解孕产妇死亡率动态方面的关键空白。
该研究涵盖肯尼亚共和国所有47个县，以县为分析单位。孕产妇死亡率（MMR）数据从地区卫生信息软件（DHIS）中提取，该软件旨在评估肯尼亚RMHCAH服务覆盖的进展水平。使用重复测量单因素方差分析对肯尼亚47个县的MMR指标随时间的变化进行建模。
一项描述性研究发现MMR平均有所下降，从2012年到2018年，每10万例活产中MMR从约170降至130。加里萨、蒙巴萨、布西亚、埃尔盖约、桑布鲁和瓦辛的MMR稳步下降。使用表格和图表展示研究结果。
我们的研究结果表明，尽管在过去四分之一世纪里肯尼亚所有47个县的相对公平性持续改善，但每个县内的覆盖情况仍不均衡。这种公平性的缺乏因县而异。每年之间以及各年之中都存在显著差异，成对比较显示2012年与除2016年和2017年之外的所有年份之间MMR存在显著差异。
