Sakaja Explains Why Mothers and Newborns Still Face Delays in Accessing Care

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Nairobi Governor Johnson Sakaja has identified three delays that he says must be addressed to improve maternal and newborn survival, from the time a mother is at home to when she reaches a health facility and receives treatment.

Speaking at the Kenya Health Summit in Nairobi, Sakaja said the county had structured its response around closing the gaps that can prevent mothers and newborns from receiving timely care.

“The first battle is won or lost before a mother even reaches a hospital,” Sakaja said, setting out the first area of concern — ensuring women can access healthcare within their communities.

Taking Healthcare to the Household

Nairobi has 7,820 community health promoters (CHPs) working across the city.

Sakaja said the promoters are the closest link to mothers and play a role in encouraging early antenatal care, following up pregnant women, identifying danger signs and connecting families to health facilities.

“Before, we used to tell people to go to hospital. These days, we take the hospital to the people through our CHPs,” he said.

Sakaja described CHPs as an important part of universal healthcare, saying their presence within communities helps identify problems before they develop into emergencies.

He also acknowledged the support given to CHPs, saying all counties had now come on board with the coverage arrangements for the workers.

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Getting Mothers to Care in Time

Once an emergency is identified, Sakaja said another delay can occur when a mother is unable to reach a health facility quickly.

“Identifying the emergency is not enough. A mother must be able to reach there when she needs it,” he said.

Nairobi operates the toll-free 1508 emergency number, which dispatches ambulances and coordinates referrals. Sakaja also pointed to the 922 National Dispatch Centre, launched in collaboration with the Ministry of Health.

Over the previous four months, he said, the emergency system had handled 4,573 alerts and referrals, averaging about 38 cases each day, with a 98 per cent response rate.

Maternity and newborn cases accounted for 54.6 per cent of all emergencies handled by ambulances during the period.

“Nairobi 1508 and 922 are not just ambulance numbers. It is part of our maternal and newborn survival system,” Sakaja said.

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The Hospital Must Be Ready to Save a Life

The third delay comes after a mother reaches a health facility. Sakaja said arriving at a hospital does not guarantee a good outcome if the facility lacks the resources needed to respond to an emergency.

“There is very little value in reaching the facility if the facility is not ready to save a life,” he said.

He said county governments must ensure health facilities have essential medicines, blood, functioning theatres and newborn care. They must also have clear referral pathways for mothers and newborns who require higher-level treatment.

Sakaja praised healthcare workers across the country, including nurses, clinical officers and doctors, as well as county health officials involved in delivering care.

“The work that they are doing is where the rubber meets the road,” he said.

Sakaja’s three-delay approach focuses on the entire journey of maternal and newborn care: identifying risks early within the community, getting mothers to health facilities during emergencies and ensuring hospitals can act promptly when they arrive.

Sakaja Praises Healthcare Workers

Sakaja praised healthcare workers involved in maternal and newborn care, including nurses, clinical officers and doctors.

He also recognized county health officials, including chief officers, directors of health and county executive committee members, for their role in delivering services.

“The work that they are doing is where the rubber meets the road,” Sakaja said.

For Sakaja, closing the three delays means ensuring mothers receive care early, reach a health facility when an emergency occurs and find a facility equipped to respond when they arrive.

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