Wednesday, June 21, 2023

Nairobi, Kenya

ADMINISTRATOR SAMANTHA POWER: I don't know whether I should say I've been waiting for this a long time or a short time. Because we have managed to pull together something very, very ambitious together in a very short time. But this really is, I think, an emblematic partnership that shows what the private sector, foundations, government, and above all, communities can do to make life better. And in this case, to save lives. 

Thank you Ambassador Whitman, for being such an unbelievable advocate for the welfare of the Kenyan people, and for the U.S.-Kenyan partnership. I can't think of an ambassador that I've encountered in any of my travels around the world who has made as big of a difference as quickly as Ambassador Whitman has. And she's not done. She's just getting started. So watch out. Watch out, Kenya. Thank you also to Safaricom CEO, Peter Ndegwa. For his partnership, as well as that of the Vodafone Foundation and the M-PESA Foundation. I think Peter captured, and I will try to reinforce, just how special this partnership is. I also want to welcome Kenya's esteemed government leaders who are here with us today, both from the national level and the local level. We know that both levels of government, when they collaborate seamlessly, it is the Kenyan people who benefit the most, and certainly that is something that is happening in this endeavor and in the health sector more broadly. Partnership across all levels of government is going to be actually key. And we are honored to have the chairperson for the Council of Governors, Anne Waiguru, as well as Cabinet Secretary of Health Susan Nakhumicha here with us – we're absolutely thrilled to have you both, thank you. 

So all of us gathered here in this room are bound by a shared commitment to the same goal. It is in many ways reflective of the way families and entire communities come together to protect and support pregnant women and their newborns, some of which I experienced during my own pregnancies – community solidarity, the kind that has friends and loved ones bringing comfort meals over to the house in advance or after a pregnancy. That kind that happens through the duration of a pregnancy where doors are held open or seats are reserved for pregnant mothers — a kind of community emerges that is bigger than the community that one feels every day. And it is a community that wants one thing which is to protect and celebrate a new life. It's a beautiful thing. 

These traditions stem not just from the desire to be part of the joy of bringing new life into the world, but also, we have to acknowledge, they come from the fact that childbirth has historically been one of the most dangerous human endeavors. Despite maternal mortality having dropped by a third since the turn of the century, the most recent numbers from the United Nations are actually still really stark. Somewhere in the world, a woman dies every two minutes from complications due to childbirth. 

Every two minutes. 

But Kenya has shown vividly the progress that it is possible to make in ensuring that child birth becomes safer for moms and for babies. So far, they have done this primarily by helping more women give birth in health facilities. For Kenyan mothers, the leading cause of maternal deaths is postpartum hemorrhage, as we've heard, catastrophic bleeding after delivery. Many, if not most of these deaths, are preventable if mothers quickly receive skilled care. But hospital fees can be expensive and some women in rural communities would need to walk more than 20 hours on foot to reach them. 

So exactly 10 years ago, in something that is talked about all around the world, the Kenyan Government began providing free maternity services at every public health facility in the country, as well as select private facilities. Simultaneously, they poured resources into building more hospitals and clinics for underserved communities. The results were immediate. One study of roughly 8,500 women conducted the year after the policy was introduced, just the very next year, showed a 15 percent increase in the number of women in urban areas using health facilities for delivery, a 15 percent increase in a single year. We are aiming for similar results here and quick results with m-mama. 

Despite Kenya's best efforts, however, maternal mortality we know remains stubbornly high. 17 mothers die in childbirth in Kenya every single day, along with 50 babies. In a single year, that's more than 6,000 mothers, for whom creating new life is lethal, and more than 18,000 babies who may not live long enough to know that they are alive. Why? Although the majority of Kenyan women now live within five kilometers of a health facility, an incredible achievement to be sure and the product of the labor of many people in this room. Five kilometers can still be too far to travel without transportation when you are in active or even emergent labor. In places where ambulances are scarce, which is in many parts of the country, mothers are often left with no choice but to walk or to bike, even while suffering contractions so painful that you can barely breathe through them. And the clinic that is just five kilometers away, may in fact not be able to handle some emergency cases that need a more intensive level of care. 

That is where m-mama comes in. As we have heard, m-mama creates an emergency response network for pregnant women and babies, especially in remote and rural communities where ambulances are not available. Women, family members, or healthcare workers call a toll free hotline number, where a trained clinical dispatcher will determine what care they need and where precisely they can get it. Then, that dispatcher will connect them to a nearby driver who will transport them. It is, at its core, a simple concept. It is an initiative though, that draws on a global community of partners who want to do everything possible to support babies and new moms. Government officials who helped raise awareness of m-mama’s potential companies like Safaricom, whose program and M-PESA that helps pay the drivers, philanthropies like Vodafone Foundation, whose funding and expertise technically was invaluable in designing an initiative that centers around mobile technology.

But m-mama also partners not just with the global community, but at its core, it is about a partnership with the communities that matter most – the communities that surround the mothers and the babies, communities that would do anything to help those mothers and babies, but just need the resources to do so. To be clear, as you saw in the video, most of m-mama’s drivers are not ambulance drivers. They're not even officially taxi drivers. We know that taxi coverage is extremely limited in more rural and remote parts of this country and of most countries. Many of the drivers who will sign on with m-mama are simply private car owners who want to help. Some have lost women in their own lives to childbirth. There was one driver in Lesotho, whose friend lost his daughter, and who desperately wished that he had been able to drive her to the hospital. Even without a personal connection, countless other drivers simply want to do something meaningful, to do something meaningful, to help the women in their communities survive childbirth.

One driver said that he once saw a laboring mother walking on the road toward a hospital clearly in severe pain and took her there for free. A service that inspired him to sign on to drive for m-mama. Another driver, a small business owner, heard about how many mothers were dying because his district of half a million only had three ambulances – along the lines of what we heard about here in Kenya in the video. Since this man began driving with m-mama, he said he feels closer to his community and he feels personally blessed when he gets to play a role in helping save a mother's life, potentially. 

The progress that m-mama has already achieved shows the power of partnering directly with communities. In the first region where m-mama was fully implemented, maternal deaths have fallen by 38 percent, newborn deaths have fallen by 40 percent – that's major. But this program isn't just effective, it’s also cost effective. In Lesotho, the government is responsible for 100 percent of ongoing costs, maintaining the app — which all of you at some point will have I hope on your phone — even just to be able to see this incredible service and paying dispatchers and drivers. The government covers 100 percent of it in Lesotho, with a population of two million, nationwide coverage will handle 2,400 transports – emergency transports a year, the cost of that $120,000. Imagine $120,000 for a country of two million that is less than the cost of purchasing and running a single additional ambulance. It's breathtaking, how cost effective this is and how effective it is for a country like Kenya. And we have real experts who will speak to you shortly. There are roughly, I gather, one million births a year, 10 percent of which are critical. That's 100,000 critical births each year, and about 25 percent of those are thought to need some form of emergency transport. Well, m-mama has the potential to transport 26,000 women each year for less than it would cost to bring five ambulances into the health system. That is an incredibly important fact. 

Today, following up very much on our Safaricom colleague, I am pleased to announce that USAID will contribute $5 million to support the rollout of m-mama. With this money, and again critically following the lead of both the national and county government leadership in Kenya, and working closely with the Vodafone and M-PESA foundations, we will work together to cover 100 percent of emergency transport needs in rural areas in the next five years. Bringing m-mama to Kenya is a giant leap forward. It proves beyond any doubt that mothers and babies are not alone. They are surrounded by people who love them, and people who may not know them, but nonetheless want to protect them all the same. If we can fully harness that love and care which we know lives in every household, in every community, at every doorstep here in Kenya. If we can give ordinary citizens the resources that they need to help save lives, we can build a world where giving birth is not a deadly experience, but simply a purely magical one. I thank you so much.

Samantha Power Administrator Power Travels to Kenya and Tanzania - June 2023 Maternal and Child Health News

Administrator Power Travels to Kenya and Tanzania - June 2023


Administrator Samantha Power is traveling to Kenya and Tanzania to reinforce the United States’ longstanding and continued commitment to both countries.