Unfortunately, the challenges that plague women’s healthcare in Sub-Saharan Africa are consistent in many areas of Kenya. One of the leading challenges is access to healthcare facilities in the first place. In a study of East African countries conducted from 2008-2017 (and published in 2020), only 42.9% of women even visited a healthcare facility in that time frame (6). In the same study, the researchers found that visiting a healthcare facility was positively correlated with education and economic status. Another finding of note was that living in rural areas was a large barrier to healthcare facility access, a trend which we will return to. An investigation by Fraym in 2015 used geospatial data to reveal that 65% of women in Kenya had not visited a healthcare facility in the past year; healthcare visiting was also found to be negatively correlated with having children and marriage (7). Barriers they found included lack of money, distance from healthcare facilities, and receiving permission to go to the facility.  

A particular concern that Kenyan women face is reproductive health. In 2021, the Center for Reproductive Rights published a report on the state of women’s sexual and reproductive health rights. They found a fundamental disconnect between the Constitution of Kenya 2010 and the on-ground situation in terms of “access to and realization of [women’s] sexual and reproductive health rights”, resulting in significant knowledge gaps in the rights guaranteed to women and girls by their government, schools, and healthcare facilities (8). This lacking information largely contributes to various specific sexual health deficiencies, such as low use of contraceptives, high rates of unintended pregnancies, high rates of HIV transmission, and high rates of unsafe abortions. The article especially highlights the failure of learning institutions to deliver sexual health (1) information and (2) supplies to school-going girls.  

A clear extension of this is the equivalent failures of Kenyan maternal health. As of 2020, Kenya’s maternal mortality rate is almost double the global average (9). The writers of this article cite the inadequacy of the government in delivering legislatively promised free maternal healthcare services. Dr. Awa Marie Coll-Seck further documents these concerns in her article for The Center for Global Health and Development. She emphasizes the importance of maternal healthcare and its impact on community well-being, pointing out its status as “the single greatest indicator of health systems that fail to meet the basic needs of the society’s poorest and most vulnerable: women” (10). Coll-Seck identifies 3 significant obstacles to maternal health in Kenya: poor funding, poor access/transportation facilities, and poor education - seemingly recurring themes in multiple facets of Kenyan women’s healthcare. 

These failures become clearer when we focus on the peripheries of, or deviances from, the current healthcare system. For example, the COVID-19 pandemic worsened various aspects of maternal health in Kenya. A nationwide survey conducted in 2020 and published in 2022 revealed these issues. Over 50% of participants expressed decreased trust in the healthcare system, which was associated with increased barriers to antenatal care, avoiding care for oneself, avoiding care for one’s infant, and feeling unsafe accessing care (11). Further, almost 50% of participants avoided postpartum mother emergency care, and over 40% of participants avoided both postpartum infant routine care and postpartum infant vaccinations. A staggering 87.7% of participants faced barriers to one or more of the following: antenatal care, family planning, postpartum mother care, postpartum infant care, delayed infant care, feel unsafe accessing care. More probing analysis revealed financial barriers and facility access barriers were consistently among the leading causes for these results. 

Evidently, women’s health and healthcare face a wide array of systemic barriers, stretching from national to local policies, from legislation to implementation, and across the many sectors that are covered under “women’s health”. Concerningly, these issues seem to interact and compound each other when considering disadvantaged communities. Next, we will further concentrate our scope on women’s healthcare in rural areas of Kenya.