Maternal and Child Health Follow along Twitte on

Maternal and Child Health Follow along Twitte on #Keny r! a. D @KNB HS S @DHS 2013 progra m 2014 Kenya Demographic and Health Survey (KDHS)

Antenatal Care (ANC) • 96% of pregnant women with a birth in the past 5 years received ANC from a skilled provider. • 20% of women went to their first ANC visit during the 1 st trimester of pregnancy, as recommended. • 58% of women had 4 or more ANC visits.

Components of Antenatal Care Among women age 15 -49 who received ANC for most recent birth in the past 5 years, percent receiving the following services: Blood pressure measured 94 Blood sample taken 96 Urine sample taken 89 Given information on breastfeeding 68 Informed of signs of pregnancy complications 58 Among women age 15 -49 with a live birth in the past 5 years, percent who: Took iron tablets or syrup Took intestinal parasite drugs 69 31

Place of Delivery Percent distribution of live births in the five-year period before the survey 17 37 27 49 15 Home 8 Private sector facility Public sector facility 46 Total 55 41 Urban Rural

Delivery in a Health Facility by County Percent of live births in the five-year period before the survey Counties with < 35% health facility deliveries • Tana River • Marsabit • West Pokot • Samburu • Turkana • Wajir 32% 26% 25% 23% 18%

Delivery in a Health Facility by County Percent distribution of live births in the five-year period before the survey Counties with > 80% health facility deliveries • Kirinyaga • Kiambu • Nyeri • Nairboi • Nyandarua • Murang’a • Mombasa • Meru • Embu 93% 89% 86% 85% 82% 82%

Problems in Accessing Health Care Percent of women age 15 -49 who report the following problems in accessing health care for themselves when they are sick: Getting permission to go for treatment Not wanting to go alone Distance to health facility Getting money for treatment At least one problem accessing health care 6 11 23 37 46

Maternal Mortality • Maternal mortality includes all deaths that occur during pregnancy, during birth, and up to 2 months after birth or the end of the pregnancy. • Maternal mortality ratio (MMR) for the 7 -year period before the survey = 362 deaths per 100, 000 live births (CI: 254, 471)

Mortality and Child Health 2014 Kenya Demographic and Health Survey (KDHS)

Childhood Mortality Rates Deaths per 1, 000 live births for the five-year period before the survey 52 39 22 Neonatal mortality 16 Postneonatal mortality 14 Infant mortality Child mortality Under-5 mortality

Childhood Mortality by Mother’s Education Deaths per 1, 000 live births for the 10 -year period before the survey No education Primary complete 51 36 40 Infant mortality Secondary+ 56 40 Under-5 mortality 51

Trends in Childhood Mortality Deaths per 1, 000 live births for the five-year period before the survey 115 74 Under-5 mortality 77 52 52 Infant mortality 2003 KDHS 2008 -09 KDHS 39 2014 KDHS

Maternal Factors Associated with High Risk of Childhood Mortality Children are at an elevated risk of dying if: • Too short birth interval: less than 24 moths after a previous birth • Mother is “too young” (under 18) or “too old” (over 40) • High birth order: mother has four or more children

Childhood Mortality by Previous Birth Interval Deaths per 1, 000 live births for the 10 -year period before the survey < 2 years 3 years 4+ years 83 60 53 36 29 Infant mortality 36 42 Under-5 mortality 44

Childhood Mortality by Birth Order Deaths per 1, 000 live births for the 10 -year period before the survey 1 2 to 3 4 to 6 57 43 36 42 Infant mortality 48 7+ 62 49 Under-5 mortality 65

Trends in Basic Vaccination Coverage Percent of children age 12 -23 months with all basic vaccinations 79 77 79 2008 -09 KDHS 2014 KDHS 65 57 1993 KDHS 1998 KDHS 2003 KDHS

Basic Vaccination Coverage by Mother’s Education Percent of children age 12 -23 months who have received all basic vaccinations 84 87 75 57 No education Primary incomplete Primary complete Secondary+

Acute Respiratory Infection (ARI) In the 2 weeks before the survey, 9% of children under 5 were ill with cough and rapid breathing, symptoms of ARI. Among these children: • 66% were taken to a health facility or provider for advice or treatment. • 53% of these children received antibiotics.

Diarrhoea In the 2 weeks before the survey, 15% of children under 5 had diarrhoea. • Among these children, 58% were taken to a health facility or provider for advice or treatment.

Nutrition 2014 Kenya Demographic and Health Survey (KDHS)

Early Breastfeeding • Provides a newborn with colostrum, a key supplement for the infant’s immune system. • 62% of newborns are breastfed within the first hour of life, and 91% within the first day. • 16% of newborns are given food or liquid other than breastmilk (prelacteal feed), although this is not recommended. • 99% of infants are ever breastfed.

Exclusive Breastfeeding by Age Percent of children exclusively breastfed 84 63 61 42 0 to 1 4 2 to 3 4 to 5 Age in months 0 to 5

Duration of Breastfeeding Median duration of breastfeeding in months among children born in the last three years 21 3. 3 5 Any breastfeeding Exclusive breastfeeding 4. 4 Predominant breastfeeding

Nutritional Status of Children Percent of children under 5 Moderate Stunted (too short for age) Wasted (too thin for height) Underweight (too thin for age) 15 18 Severe 8 26 3 1 4 9 2 11 *Based on the 2006 WHO Child Growth Standards

Stunting among Children by County Percent of children under 5 • • Counties > 33% Kitui West Pokot Kilife Mandera Bomet Tharaka-Nithi Narok 46% 39% 36% 33% • • • Counties < 18% Kirinyaga 17% Nairobi 17% Garissa 16% Kiambu 16% Nyeri 15% *Based on the 2006 WHO Child Growth Standards 16

Trends in Nutritional Status of Children Percent of children under 5 38 36 35 Stunted 26 18 16 16 Underweight 7 6 7 1998 KDHS 2003 KDHS 2008 -09 KDHS Wasted 11 4 2014 KDHS