Hon. Ekwe Ethuro, Speaker of the Senate;
Hon. Jessica Mbalu, Representative for Hon. Justin Muturi;
Representatives of the Ministry of Health and the Ministry of Devolution and Planning;
UNFPA Country Representative, Mr. Siddharth Chatterjee;
WHO Representative Ms. Marleen Temmerman;
Members of the Senate; Members of the National Assembly;
Members of the various House Committees;
Ladies and Gentlemen:
Hamjambo! Habari zenu?
I am honored to join you today for this Advocacy meeting on Accelerating the Attainment of Millennium Development Goal 5 in Kenya. Now, “Millennium Development Goal 5” is a pretty dry name. So let me put it another way. We are here today about the health of mothers. We are here about the health of families. We are here because Kenyans do not want their country to be one of the 10 most dangerous countries in the world for mothers to give birth. We are here about our shared future.
As then UN Secretary General Kofi Annan put it in his UN Message for the New Millennium in 1999:
“More than ever before in human history, we share a common destiny. We can master it only if we face it together.”
Our future depends on our families, on our mothers, and on our children. We can assure the future of humanity only if we work together to protect them, keep them healthy, and give them the care they deserve. It’s an obligation of all governments; it’s an obligation of all leaders; it’s an obligation we all share.
I have been privileged to be in Kenya for now more than two years. During that time, I have visited hospitals, clinics, and dispensaries across this great country. From Nairobi, to Mombasa, to Kisumu, to Turkana, I have spoken with Kenyans of all ages. From doctors in an Eldoret hospital treating critically-ill patients to young mothers holding newborn babies at the Kalalu dispensary in Laikipia, I have listened to the concerns Kenyans have about their health care system. They want what we all want. Quality, affordable, accessible health care. And, they care deeply about the health of mothers, about safe child birth, and about access to family planning.
You are Kenya’s leaders. As Cabinet Secretaries, Senators, members of the National Assembly: you hold Kenya’s future in your hands. You make the decisions for your nation. Only you can ensure maternal health and family planning by adopting well-informed laws and policies, and allocating budgets to make those laws and polices a reality. As Kenya’s First Lady, Her Excellency Margaret Kenyatta, has rightly and powerfully reminded us, “No woman should die while giving life.” Legislators bear a heavy burden of ensuring there is adequate funding to meet the maternal and family planning needs of your country. And, members of the executives at the national and county levels have an obligation to implement, effectively and efficiently, health care policies and programs to deliver these services.
In recent years, Kenya has taken important steps forward. I commend President Kenyatta and his government for its decision to offer all mothers free medical services for child birth. And, Kenya has shown a strong commitment to family planning as reflected in the National Population Policy. Current health service statistics show that the number of women who use family planning services in Kenya has been increasing steadily – an excellent sign of progress.
And yet, Kenya’s challenges remain stark. The maternal mortality ratio remains at an unacceptably high level of 488 deaths per 100,000 live births. And this ratio has almost remained constant since 1990. The top causes of maternal mortality in Kenya include hemorrhage, complications from hypertensive disease in pregnancy, sepsis and abortion complications. HIV-related complications are the highest indirect cause of maternal mortality in Kenya. To meet these challenges, much work remains to be done and resources are essential. In Kenya, today, only about seven percent of government spending goes to health and a declining part of that to maternal and child health and family planning. As a rising middle income country, your people need more.
As Kenya seeks to meet these challenges, the United States and other partners stand with you. We are your allies in this crucial effort. We are ready to support you, Kenya’s leaders, as you chart your course.
Let me put meaning behind that statement with a few examples of the U.S. Government’s assistance here in Kenya. Each year, we invest over 50 billion shillings here in health care programs alone. We share Kenya’s commitment to achieve Millennium Development Goal 5 and to protect the health of mothers. Kenya is one of 24 priority partner countries in the USAID initiative to end preventable maternal and child deaths. So, what precisely are we doing to help? American assistance for these health services, under the well-known names of APHIA and the Maternal Child Survival Project, focuses on these key areas: training health workers, including skilled birth attendants, to provide critical services across the country; educating citizens, including on family planning, on prenatal care and on danger signs in pregnancy; and providing direct support to the government, including for developing national strategies and policies, providing contraceptives and equipment, and supporting county service delivery.
The U.S. Government has been working on the challenges of maternal health with the Kenyan Government through health institutions and through the National Council for Population and Development since 2005. And we have tailored our support along the way as Kenya’s institutions have changed. For example, today we proudly support the Government of Kenya on scaling up Emergency Obstetric and Neonatal Care in the counties, now that this key function has been devolved. USAID also currently supports many counties to enhance the skills of midwives so that they can better respond to emergencies that arise during childbirth. We pledge our continued support in these areas, and we urge the counties to complement these efforts by providing the needed health infrastructure, supporting trained health staff and providing contraceptives and essential lifesaving medicines to women.
Several weeks ago 15 Governors signed a pledge to support maternal and child health initiatives, to do all that they can to save lives. I urge you, as leaders, to make the same commitment to the future of Kenya.
In discussing maternal health and family planning, it is important too to highlight the crucial role of civil society. Across Kenya, there are national and international NGOs, women’s organizations, churches, unions, youth organizations, private sector groups, philanthropists, and community service groups all providing critical health care services. For all of the questions that are sometimes asked about civil society, the idea behind it is simple. Civil society is people banding together to solve a common problem and to create a better life. The development work that we do in Kenya, and around the world, would never be possible without our partners in civil society. NGOs work with us, and with the Government of Kenya, to educate citizens and to provide core services in hard-to-reach areas. They care for the sick. They help mothers deliver babies. They feed millions of schoolchildren. They protect wildlife. They provide a voice, advocating for the most vulnerable members of our society, including young mothers who desperately need support. In short, civil society is essential. To play their critical role, civil society must be allowed a wide space to operate – it must be given the greatest possible freedom, in line with your constitution, to help all Kenyans make a better life.
Now, when we talk about U.S. assistance in Kenya for maternal health and family planning, sometimes people ask me: why do we do this? We do it because we believe we have a common destiny, as human beings sharing this world together. We do it because we believe investing in people – their health, their security, their prosperity – is the key to a better future for us all.
In August of this year, President Obama hosted the first U.S.-Africa Leaders Summit – the largest engagement any president has held with African leaders. We discussed many topics there, from partnering to enhance global security, to increasing trade and investment to create jobs. But each of these conversations had a common thread: the United States is investing in the people of Africa. We do it because people are Africa’s, and Kenya’s, greatest resource. We must protect them, and we must help them thrive. It is the only way we can master our future.
Kenya faces many challenges. But Kenya is a great country and Kenyans are a great people. I know you can succeed in protecting the health of mothers.
So, let us all join hands to protect the women and families of Kenya. Together, we can build a better world for them and, in so doing, for all of us.
Pamoja, tusonge mbele!