Thank you Mr. President

wed
And my credit this week goes to President Uhuru
Kenyatta. I think he has really demystified the
institution of the presidency and brought it closer
to the kenyan people by attending a crusade here,
a wedding there, an award ceremonies and
apprearing on a documentary marketing kenya as a
perfect destination for movies. Thats how a leader
does it while rulers wallow in the aura of self
importance and sorrounded by contingents of
mean security men who protect them from the
same people who elect them.Thank you Mr.
President though I still hold that you need to cut
down on your motorcade and fire one Francis
Kimemia, he is not indispensable

Reflections on Maternal Healthcare and Maternal Mortality in Kenya

maternal

AN OPEN LETTER TO H.E UHURU MUIGAI KENYATTA
I am honoured to have the opportunity to write to you. I must admit that I am inspired by your energy and enthusiasm to lead our country and to deliver on the promise of a new Kenya. I have no doubt in my mind that you will deliver on your promise. May the almighty God provide you with wise counsel as you journey through the process of healing and building our country. May he sustain you through the challenges that come with the task that is ahead of you.
Allow me to provoke your thought on the state of Maternal Healthcare in Kenya as one of the sectors of our development that need swift and urgent attention by your Excellency’s government.
I know of your government’s commitment to abolish maternity fees in Kenya within the 1st 100 days in office. This is a move that deserves huge applause seeing that thousands of women will henceforth access maternities to ensure that every Kenyan child is born in the safety of a hospital. However, this move alone cannot and will not solve the challenges we face with our maternal healthcare systems. This move alone will not help us save the lives of the many infants and pregnant mothers we lose every year to pregnancy related complications.
The 5th Millennium Development Goal (MDG 5) to reduce maternal mortality by 75% during the period 1990-2015, is by far the least MDG on track to be fulfilled in Kenya as in most of Africa. Women continue to suffer and die unnecessary disabilities because of complications of pregnancy. According to the 2009 Kenya Demographic and Health Survey (KDHS) the current ratio of maternal deaths in Kenya stands at 488 deaths per 100,000 births, a sharp contrast from developed countries that register less than ten deaths per 100,000 births.
This is a matter of great concern, as these deaths arise from well-known preventable causes-obstructed labour, complications of unsafe abortion, infections, haemorrhage and high blood pressure. Yet all these are treatable. In fact pregnancy is not a disease. With skilled health care during pregnancy and delivery, provided in an adequately supplied and equipped health facility, these premature deaths can be prevented.
The ambiguity in the jubilee coalition’s manifesto on the solutions to the challenges facing the healthcare system in Kenya and in particular maternal healthcare is overwhelming. While your coalitions manifesto clearly underscores these challenges, it is not very clear on the specific interventions and key performance indicators laid out to improve the maternal healthcare system and save the lives of our women.
Allow me to point out a few of the challenges that bedevil our maternal healthcare system and offer my two sense solution.
In general, 15% of all pregnant women are at risk of serious obstetric complications. All pregnant women should therefore have access to quality basic or comprehensive emergency obstetric care.
Obstetric care in Kenya is limited, especially in rural areas where the majority of women live. The services that are available, whether provided by the government or private medical practitioners, are mainly concentrated in urban areas, and are thus inaccessible to the majority of women. Maternal health facilities in Kenya are also often poorly equipped and lack important components of maternal health, i.e., normal delivery, postnatal care and emergency services (NCAPD et al., 2004). This means that even in cases where the mother gets to the health centre, there is no guarantee she will get the services she needs whether for free or at a fee.
The risk of death for mothers is highest immediately after delivery (the 48 hours after delivery). Postnatal care is therefore essential to prevent complications after childbirth. Only 42% of women receive postnatal check-ups within two days of delivery, and more than half of women who give birth do not seek postnatal care. These figures are worrying, given that pre- and postnatal care are critical to women’s health. The mothers mostly affected are those in the lowest wealth quintile, those with low levels of education and those in remote areas like North Eastern Province where 79% of women do not receive postnatal care. Targeting services to such areas would potentially have a great impact on mortality levels.
The risk of maternal death increases with each pregnancy, and with pregnancies that are too close together. Satisfying women’s unmet need for family planning, that is, ensuring access to contraceptives by women who want to space or avoid pregnancies but are currently not using contraception, could reduce unintended pregnancies, unsafe abortions and maternal deaths.
Kenya continues to have a high unmet need for family planning. About a quarter of currently married women who want to space or limit their births are not using any form of contraception. Access to modern contraceptives would enable women to avoid unwanted and too many pregnancies, which can lead to unsafe abortions and complications associated with too many births. It could also reduce maternal deaths by more than one-third (UNFPA and Guttmacher, 2009).
Antenatal, delivery, postnatal and other obstetric care services provided in public health facilities are substandard. Service provider harassment and mistreatment of women in public health facilities in Kenya is reportedly rife. Providers are not only frequently unfriendly to women, but also regularly fail to answer their questions, ask them for important routine information or counsel them during antenatal care consultations.
Many if not most service providers also lack more advanced skill, for example recognizing and treating life threatening complications. It is important to improve the performance of health care providers by increasing training opportunities and making them accountable to the public.
Kenya’s public health sector capacity to respond to the needs of women is limited. The sector is under-financed and characterized by shortages of most basic essentials. It frequently suffers stock-outs of medications and basic supplies including contraceptives, shortage of personnel and a lack of key equipment.
Investing in health systems is critical to the improvement in maternal health and achievement of the MDGs. Perhaps more to the point, as indicated above, if adequate family planning services were available there would be fewer unintended pregnancies and thus much less demand for induced abortions.
It is possible to reduce maternal deaths if women have access to skilled attendance at delivery, emergency obstetric care when needed and family planning. This would go a long way in reducing mortality and improving the health of women, and as a result move Kenya closer to achieving the MDG 5 targets on maternal health and the goals of Vision 2030.
Political and financial commitment is needed to ensure maternal health is protected. Strengthening health systems to ensure the country can deliver proven interventions effectively is critical. We must Increase government allocation for contraceptives to ensure that women who want to space or avoid pregnancy have access to modern contraceptives. The government must also provide adequate and sustained government funding for maternal health, mainstream the output-based approach project piloted in Nairobi, Nyanza and elsewhere, train health workers appropriately to improve client relations and quality of care, make health providers more accountable to the public in order to improve their performance, e.g., through enforcement of Citizen Service Charters and individual performance contracts with the government, enforce existing laws and policies against early marriages and female circumcision.
These solutions are by no means comprehensive. There are a myriad of other things the government can do to improve the state of Kenya’s maternal healthcare. But more importantly we must make sure that we protect our women and babies. Few or no lives should be lost to pregnancy related complications.
Every Kenyan is guaranteed the right to life in Kenya’s Constitution and the government has a duty to protect each life no matter what.

Yours faithfully
Concerned citizen

President Uhuru Kenyatta’s Speech at the Official Opening of the 11th Parliament

President Uhuru Kenyatta’s Speech at the Official Opening of the 11th Parliament (Download)

Speakers of the Senate and National Assembly,
Honourable Members,
It is a great honour to address this opening session of Parliament combining both Houses. I congratulate Honourable members on your election and nomination to both the Senate and National Assembly.

My congratulations also go to the Speakers of the Senate and National Assembly together with their respective deputies on their elections, the Leaders of the Majority party and Minority Party as well as their respective deputies on being
elected to their positions. I want to especially congratulate the record number of women in both Houses – an indication of Kenya’s commitment to achieving gender parity and equity. I commend the last Parliament for the passage of numerous Bills and for meeting constitutional deadlines. I wish all Honourable Members the best as you steer the legislative and policy…

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Kenya: The Supreme Court Judgement on the Presidential Petitions

FULL JUDGEMENT -Petition No. 5 of 2013 Judgement…Final [2] – April 16, 2013 (download)

The Supreme Court Judgement on the Presidential petitions.

REPUBLIC OF KENYA
IN THE SUPREME COURT OF KENYA AT NAIROBI
(Coram: W.M. Mutunga, Chief Justice and President of the Supreme Court; P.K. Tunoi; M.K. Ibrahim; J.B. Ojwang; S.C. Wanjala; N.S. Ndungu, SCJJ.)

PETITION NO. 5 OF 2013

-BETWEEN-

RAILA ODINGA ….……………………….…………………..………..PETITIONER
-AND-

1. THE INDEPENDENT ELECTORAL
AND BOUNDARIES COMMISSION
2. AHMED ISSACK HASSAN ….………….RESPONDENTS 3. UHURU KENYATTA
4. WILLIAM SAMOEI RUTO

AS CONSOLIDATED WITH PETITION NO. 3 OF 2013

-BETWEEN-

1. MOSES KIARIE KURIA
2.DENIS NJUE ITUMBI ……………….…..PETITIONERS
3. FLORENCE JEMATIAH SERGON

-AND-

1. AHMED ISSACK HASSAN
…….…….…….RESPONDENTS
2. THE INDEPENDENT ELECTORAL
AND BOUNDARIES COMMISSION

AND AS CONSOLIDATED WITH PETITION NO. 4 OF 2013

-BETWEEN-

1. GLADWELL WATHONI OTIENO
2. ZAHID RAJAN ..……………………..PETITIONERS

-AND-

1. AHMED ISSACK HASSAN
2. THE INDEPENDENT ELECTORAL
AND BOUNDARIES COMMISSION …….……….….RESPONDENTS
3…

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Did Uhuru victory divide Kenyans? Well, that is what all elections do- Charles Onyango Obbo (Cobbo)

UK

On Tuesday, Uhuru Kenyatta was sworn in as Kenya’s fourth president and William Ruto as deputy, the first person to hold the position after it was introduced by the 2010 Constitution.

President Kenyatta promised to serve all Kenyans, a reference to the now widely discussed fact about how this election left Kenya “deeply divided down the middle”.

Commentators on TV, columnists in newspapers, churchmen and women are agonising, some very worried that Kenya could end up being “ruled by the Kalenjin and Kikuyu”, with the rest locked out, stewing in the anger of alienation, and ready to burn the country down — so everyone loses — at the next election.

I fear Kenya is letting sentimentalism get in the way of hard-nosed realism. Had Raila Odinga won, Kenya would still have been pretty much “divided down the middle”, as it likely did, with a Kenyatta victory.

Perhaps the only candidate who wouldn’t have divided Kenya would have been the earthly Mohammed Abduba Dida, who came in fifth. Dida was the surprise of the race, beating veteran Martha Karua, considered a far substantial figure.

Which raises the question, if Kenyans dislike division, why didn’t they vote Dida? The best answer is that elections are messy and divisive, not just in Kenya, but everywhere.

In America, when George Bush Jnr was president, Democrats hated him so much, many kept threatening to flee to Canada and France and quite a few actually did.

Things have been worse with President Barack Obama. The last campaigns in US were nastier than the Kenyan one. After Obama won, citizens in 18 states, most of them staunch Republicans, petitioned to secede from the US rather than be ruled by him.

The choice of leaders and rulers has always been traumatic. In times gone by, when a prince became king, he would slaughter all other princes who might eye his crown. What makes the difference, however, is how these divisions are handled after the vote.

Ethnic head count

One of the most notable examples is US President Abraham Lincoln (1861-1865). The chap lost various elections a record eight times, but didn’t give up.

At the end of 1860, he eventually won the presidency. The US was deeply divided over the issue of slavery. Lincoln opposed the extension of slavery outside the south. So when he won the presidency, seven slave states in the south formed the Confederacy, and declared secession.

Lincoln went to war with them, won and abolished slavery in May 1865. He was assassinated a month later.

Why did Lincoln make such a difference in four short years and prevail? Some historians argue it is partly down to his skill in managing factionalism.

When he became president, three of the men he appointed in his Cabinet — Attorney-General Edward Bates and Cabinet secretaries Salmon Chase and William Seward had all run against him in 1860.

That would be the equivalent of Kenyatta appointing Raila, Kalonzo Musyoka and Musalia Mudavadi to key Cabinet posts in his government. That, in all probability, would be the easier thing to do. The more difficult thing would be for Raila to accept because, as several columnists have already commented, it would “diminish his status”.

Therefore, while Kenyatta might not do a Lincoln, he has other options. Closer home, there is the case of Rwanda, which teaches us that dedication to transparency can heal some wounds. Take one example. Every year, Rwanda sends over 1,000 students on state scholarships on specialist courses abroad.

Critics accuse the ruling Rwanda Patriotic Front of being a “minority Tutsi” regime that excludes the majority “Hutu”. So every year, the short list of the students for the scholarships is published all over the country. Then the final list of those who are finally selected is also published.

Though the students’ ethnicity is not listed, still the tribal mathematicians count to see how many Tutsi and Hutu have got the scholarships. Generally, many have been happy with what the figures tell them.

As long as Kenyatta is alive to the fact that some people will always do an ethnic head count, and he gives them good numbers to work with, he can pull it off.

 

 

 

Did Uhuru’s Win Divide Kenya?

OEN LETTER TO KIBUNJIA MZALENDO: Apolgies and Resignation Demand

The Kenyan Artivist

Dear Dr. Kibunjia,

You as the Chairperson of the National Cohesion and Integration Commission of the Kenyan government was appointed to advance the interests of the Republic and the people of Kenya in an impartial and rational manner. As a citizen of Kenya, I object to the way in which you are abusing your high office to promote both your own personal agenda and the interest of a few people and a specific community. You obviously have a ‘blind spot’ when it comes to Kenya; you lose your sense of objectivity and rationality when dealing with Kenyans.

Most recently you have used your platform and title in an active campaign to prevent Kenyans – and especially bloggers – from exercising their freedoms of speech, expression and right to information, with a view of gagging an discussions concerning the just concluded General Elections. This is but one example of your irrational…

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Is an electoral college the way out of our divisive elections?

From Tyranny to safety of Numbers by Okiya Omtata
Kenya is a multi-ethnic state, composed of 42 officially recognised tribes. The 2009 census figures give the ethnic composition as follows (out of a total population of 38.6 million): Kikuyu 17%, Luhya 14%, Kalenjin 13%, Luo 10%…, Kamba 10%, Kisii 6%, Mijikenda 5%, Meru 4%, Turkana 2.5%, and Maasai 2.1%. About 9% of the population consist of smaller groups below 1% each, and Non-African groups (Arabs, Indians and Europeans) are estimated to total to about 1%.
Ever since Kenya’s independence in 1963, Kenyan politics have been characterized by ethnic tensions and rivalry between the larger groups, escalating into the 2007–2008 post-election violence that nearly plunged the country into a civil war. There is need to raise one million signatures as required under the popular initiative (article 257) to amend article 136 of the constitution to provide for the election of the president through a county based electoral system as opposed to the current one-person-one-vote system which has been reduced to a mere census of tribal numbers. The beauty of Kenya’s diversity is such that there is no majority tribe. There are large tribes but none is more than 50% of the population. For example, its largest ethnic group, the Kikuyu, make up for less than a fifth of the total population. In reality, therefore, Kenya has a safety of numbers, and not a tyranny of numbers, among its ethnic groups. However, to exploit this reality, Kenya must institute a presidential electoral system where all ethnic groups, large and small, feel safe and important in the prosecution of national affairs, especially as embodied in the election of the President and the Deputy President, who are symbols both of national consensus and of the unity of the Republic.
The system must move the country away from the current state of affairs where large tribes tyrannise smaller ones during elections, and where the main criteria for occupying the Presidency is the numerical size of the ethnic blocks backing a candidate. The system must boost the process of devolving power from Nairobi, an act designed to improve local governance and to reduce marginalization and the risk of conflict between communities. Such as system is only possible where the President and the Deputy President are not elected directly in a popular vote nationally. Instead, they are elected indirectly by popular vote on a county-by-county basis.
The United States of America elects its politically powerful president via an electoral college designed to ensure the election of the president through a popular vote and to protect the interests of the states. The founders of the USA wanted each state to have a voice in the election of the president and, therefore, even small states have political influence nationally. The US Constitution specifies that the president and vice president be chosen through the votes cast by electors chosen by the states, rather than by a direct popular vote. Hence, the President and Vice President are not elected directly by the voters. Instead, they are elected indirectly by “electors” who are elected by popular vote on a state-by-state basis. And a candidate can become president without having obtained the highest number of votes nationally in the sole or final round of popular voting. The county electoral system is a block, or weighed, voting system that is designed to give more power to the counties with more votes, but allows for small counties to swing an election. Under this system, each county is assigned a specific number of votes that is proportional to its population, so that each county’s power is representative of its population. So, while winning the popular vote may not ensure a candidate’s victory, a candidate must gain popular support of a particular county to win the votes in that county.
Each county is apportioned electoral votes equal to the number of its elected Members of National Assembly plus one elected Senator. Hence, there would be 337 electoral votes, being 290 Members of the National Assembly and 47 Senators elected into Parliament. The county electoral votes are taken on a “winner-take-all” basis. That is, all electoral votes in a county are given to the winning presidential candidate. To be elected President, one must get at least 169 votes, being 50% + 1 of the electoral votes.  The goal of any candidate would be to put together the right combination of counties that will give him or her 169 electoral votes.
Should none of the candidates win 169 electoral votes a runoff between the top two candidates will be conducted. Under the system, and using IEBC figures, results of the 2013 elections would be:
Raila 197 votes
Uhuru 134 votes
Mudavadi 6 votes
Muite 0 Votes
Dida 0 Votes
Karua 0 Votes
Kiyapi 0 Votes
Kenneth 0 Votes
The current distribution of Electoral Votes per county would be as follows:
Mombasa 7
Kwale 5
Kilifi 8
Tana River 4
Lamu 3
Taita Taveta 5
Garissa 7
Wajir 7
Mandera 7
Marsabit 5
Isiolo 3
Meru 10
Tharaka Nithi 4
Embu 5
Kitui 9
Machakos 9
Makueni 7
Nyandarua 6
Nyeri 7
Kirinyaga 5
Murang’a 8
Kiambu 13
Turkana 7
West Pokot 5
Samburu 4
Trans Nzoia 6
Uasin Gishu 7
Elgeyo Marakwet 5
Nandi 7
Baringo 7
Laikipia 4
Nakuru 12
Narok 7
Kajiado 6
Kericho 7
Bomet 6
Kakamega 13
Vihiga 6
Bungoma 10
Busia 8
Siaya 7
Kisumu 8
Homa Bay 9
Migori 9
Kisii 10
Nyamira 5
Nairobi 18
TOTALS 337