Aga Khan University, Kenya

Changing Kenya’s Future – Ending Preventable Deaths among Young Women

Reproductive health care

Young women’s advancement is the change needed to propel Kenya towards well-being and prosperity – yet thousands die in childbirth and of preventable cervical cancer

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Lead Organization

Aga Khan University, Kenya

Nairobi, Nairobi, Kenya

http://www.aku.edu/pages/east-africa.aspx

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

‘When a mother dies, the village crumbles’. In Kenya, too many young women die during childbirth and of cervical cancer. Yet, we know what to do: quality of care around childbirth and family planning reduce maternal mortality; HPV vaccination of young girls and screening and treatment of early lesions in adult women are proven solutions to prevent cervical cancer. 100&Change will enable us to end this silent tragedy. Together with local authorities, stakeholders and communities, we propose an investment in quality and equitable services at childbirth and in prevention of cervical cancer, which – together with a paradigm shift towards governance, leadership and accountability – will make the difference.Preventable death or lifelong disability are daily realities for young Kenyan women, but through capable stewardship, proven interventions, and women’s leadership, we will transform not only the lives of thousands of women and their families, but the entire future of Kenya.

Problem Statement

In Kenya, far too many young women die of preventable causes during childbirth or of cervical cancer. Although great strides have been made in reducing maternal mortality, an estimated 6,300 Kenyan women, or one out of 270 pregnant women, die annually during childbirth, reflecting low utilization and quality of health services. Despite improved coverage, quality of care remains the major challenge. Cervical cancer is the second most frequent cancer among women with 5,250 new cases diagnosed annually, or one in 3,000 Kenyan women, and the leading cause of cancer-related deaths with 3,286 lives lost in 2018. Because of the current low rates of HPV vaccination, and only one in four Kenyan women being screened, the number of deaths from cervical cancer will double by 2025. Young women in Kenya face multiple and intersecting barriers stemming out of power differentials and gender norms alongside a worrying disproportionate morbidity and mortality burden. Kenya wants to invest in effective accountability to radically eliminate the needless deaths of young women. Public and social accountability at local levels is still dysfunctional and deficient. Therefore, strengthening accountability of all actors in the health system as well as empowering communities - and particularly women - need to be accomplished urgently as demanding quality and equitable health services will be the pathway to ensuring full realization of women’s health and rights, including sexual and reproductive health and rights, and ultimately ending preventable deaths among young women.

Solution Overview

Our project will contribute to a significant reduction in mortality and morbidity related to two conditions that disproportionately affect young women and impact their quality of life and contribution to family and community: complications during childbirth, and cervical cancer. Access to quality childbirth services and family planning, HPV vaccines for young girls and screening for early detection and treatment of cervical pathology are low-hanging fruits to fight these deaths. Strengthening health systems governance and management, and endorsing public and social accountability through multipronged strategies are essential in advancing the progressive realization of the right to women’s health and quality healthcare. Kenyan counties (47), key decision-makers in the devolved health system, are ready to mandate centers of excellence in women’s health, based at level 4 and 5 referral hospitals, to scale proven evidence-based interventions and to be accountable for the quality of women’s healthcare in their facilities as well as in their catchment area. In combination with community outreach, awareness-raising and supported by innovative tools, these centers of excellence will ensure continuous mentorship to maternal and new-born care, as well as cervical cancer screening and treatment, with learning at their high-volume centers and cascading this to lower level facilities. By end 2025 our partnership will be a gamechanger to reduce childbirth mortality by 70% in Kenya, and to increase HPV screening of women at age 30 to 70%, followed by further diagnosis and treatment. Relevant indicators will measure progress towards the desired outcomes.

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