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Despite increased investment in healthcare by county governments, the Council of Governors (CoG) has raised concern over declining attendance for recommended antenatal care visits, warning that the trend could undermine efforts to reduce maternal and newborn deaths across the country.
The Council's 2025/26 State of Devolution highlighted maternal health among the areas requiring renewed attention despite significant progress in strengthening county health systems.
The report indicates that counties have continued to prioritize health, which accounts for the largest share of the county workforce at 35.38 per cent, reflecting sustained investment in frontline service delivery. County governments have also expanded health infrastructure, strengthened primary healthcare networks and increased financing for health services.
However, the CoG noted that fewer expectant mothers are completing the recommended antenatal care contacts, a trend that raises concerns over early detection and management of pregnancy-related complications.
Health experts consider regular antenatal care critical in monitoring the health of both mother and child, detecting high-risk pregnancies and ensuring timely interventions that contribute to lower maternal and neonatal mortality.
Council of Governors Chairperson Ahmed Abdullahi said counties had made notable progress in expanding access to essential services but acknowledged that gaps remain in key sectors, including healthcare.
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"Devolution remains one of Kenya's most transformative governance shifts. Outstanding and selfless service is what is demanded of us leaders by the Constitution. Our ultimate priority must be to deliver quality, accessible and affordable services to all Kenyans with the aim of closing the socio-economic divide," Abdullahi said.
He urged county governments to ensure that public resources translate into better outcomes for citizens.
"Every shilling from the equitable share, own-source revenue and conditional grants must be accounted for through changed lives, improved livelihoods and prosperity of all Kenyans," he said.
Beyond maternal health, the report cites broader gains in healthcare delivery, including stronger primary healthcare systems, increased community health interventions and documentation of innovative county-led models aimed at improving service delivery and advancing universal health coverage.
The report concludes that while counties have recorded significant gains since devolution, improving maternal health outcomes will require renewed efforts to encourage expectant mothers to complete the recommended antenatal care visits alongside sustained investment in quality health
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