NAKURU, Kenya, Feb 6 (Thomson Reuters Foundation) -
Everline Achieng has a disability you only notice when she
stands. She walks with the support of a crutch since losing the
use of her right leg at the age of eight due to an unknown
illness that also put an end to her education.
In 2010, three years before the government introduced a free
maternity services programme, she delivered twins by caesarean
section at the Rift Valley General Hospital, but they died after
developing breathing problems.
On top of suffering the loss of her babies, Achieng had
difficulties in hospital as the bed she was given was high and
fixed. "It was a painful struggle climbing onto it," she
At the hospital where she delivered, since renamed as Nakuru
Level 5 Hospital, the wards are now equipped with adjustable
beds - a sign that health services are becoming more inclusive.
But one thing has not changed: the lack of data on disabled
In 2013, health functions were devolved to Kenya's 47
counties, which are bound by the 2010 constitution to implement
health policies developed at the national level, including free
But rights activists say those services have not been
adapted for disabled women, partly because the government is not
gathering information on them.
Achieng is counted as one of the nearly 5 percent of the
Kenyan population suffering some form of disability, as captured
in a 2007 national survey.
But that data is now around a decade old - and more recent
censuses, such as the 2014 Kenya Demographic and Health Survey,
do not include information on disabled men, women or children.
In hospitals, the patient sheet filled in by pregnant women
has no question asking if they have a disability.
Information gathered by county hospitals is fed into the
Ministry of Health's database, which can be used by other
ministries and development agencies. But the oversight in the
data collection makes it impossible to tell how many disabled
mothers are delivering at hospitals.
Dr. John Murima, medical superintendent at Nakuru Level 5
Hospital, could not provide figures on disabled women giving
birth at the public facility.
"We use certain tools to capture data for patients - for
example, their general health. But we do not have a tool that
captures people with disability as a patient," he said.
Given that governments and donors rely on data to identify
development concerns, Kenya's lack of statistics on disabled
people accessing health services means their needs are at risk
of being ignored, experts warn.
President Uhuru Kenyatta introduced the Free Maternity
Services Programme in mid-2013, aimed at relieving all women of
having to pay user fees for delivery at public hospitals.
Annually, 1.6 million women in Kenya deliver babies,
according to the health ministry. Of these, around 1 million
give birth in public hospitals, while 200,000 do so in private
hospitals and 400,000 deliver at home or in unhealthy
Even women who do not pay into the National Hospital
Insurance Fund (NHIF), a state health insurance scheme, are
eligible for free delivery.
Last October, the health ministry extended free maternity
services under a programme called "Linda Mama, Boresha Jamii"
("take care of a mother, improve the family").
Under this initiative, expectant mothers who cannot afford
insurance cover can now access ante-natal, delivery, post-natal
and health services for their child for a year.
Dr. Peter Kimuu, head of the health ministry's policy,
planning and healthcare financing department, said those
eligible must register first for a free NHIF card.
"Every woman has a right to access equal and quality health
services in any hospital," he said.
But for Achieng, the unique needs of disabled mothers extend
beyond free maternity services.
"We really need help to start income-generating activities
to be able to afford a healthy lifestyle," she said.
The global Sustainable Development Goals (SDGs), launched
last year, state that countries should promote gender equality
by eliminating all forms of discrimination against women.
But without data to demonstrate the scale and urgency of the
problem, securing funding for programmes to support disabled
women is likely to take longer than the 15-year life span of the
SDGs, argued George Gongera, a professor of strategic management
and international relations at the Co-operative University
College of Kenya.
Dr. David Ole Sankok, chairperson of Kenya's National
Council of Persons with Disabilities, which is charged with
collecting data on disabled people, said no audit had been done
on women with disabilities seeking maternity care.
But trying to gather such information could draw strong
reactions from the target group, he warned.
"This is a private affair and you can't start asking if she
has a disability. She will begin to think that she is not
supposed to be pregnant because of her disability," said Sankok.
Despite the sensitivity of the issue, medical staff are
being trained to handle disabled patients better, and the
council is pushing for prescriptions to be offered in braille
for the blind, he added.
Stephen Obama, Nakuru County coordinator for persons with
disabilities and development, said programmes targeting disabled
women must be implemented urgently if they are to enjoy good
"Poverty is a major problem facing persons with disabilities
- and for a pregnant woman it becomes even more complicated
because they have special needs to meet, like healthy food - and
that means money which they don't have. We want government to
note this as a troubling issue," he said.
Last year, the Ministry of Health recognised the poor state
of data collection in a key investment framework, noting that it
is problematic for planning and monitoring.
Faith Njahira, a disability rights advocate, said the
government should utilise information collected by community
health workers from households - which includes disabilities
among family members - to compile disaggregated data.
That would be a key step towards recognising the problem,
said Gongera. "It is very difficult to consider an issue, even
when it is an emergency... when you have no data to show," he
(Reporting by Moraa Obiria; editing by Megan Rowling. Please
credit the Thomson Reuters Foundation, the charitable arm of
Thomson Reuters, that covers humanitarian news, climate change,
resilience, women's rights, trafficking and property rights.