Kenya has achieved significant reduction in mortality among children aged below 5 years but child deaths remain unacceptably high. The Kenya Demographic Health Survey (KDHS 2022) shows that under-five mortality rate has decreased from 52 to 41 deaths per 1,000 live births, and infant mortality rate from 39 to 32 deaths per 1,000 live births. The neonatal mortality has decreased at a slower rate and currently stands at 21 from 22 deaths per 1,000 live births. According to the same report, neonatal deaths account for 66 percent of infant mortality and 51 percent of under-five mortality. Birth asphyxia, neonatal sepsis, pneumonia, diarrhea, malaria, and malnutrition are the top causes of death among children under the age of five. The majority of these deaths can be prevented by implementing well-known, high-impact evidence-based interventions. The SDG targets to reduce neonatal mortality rate to 12 deaths per 1,000 live births and under 5 mortality rate to 25 deaths per 1,000 live births by 2030. In response to this, the Ministry of Health has implemented several initiatives aimed at improving the quality of care provided to children including small and sick newborns (SSNBs) in health facilities across the country. One of these initiatives is the development of the Kenya National Standards for Improving the Quality of Care for Children including the Small and Sick Newborns. These have been adapted from the WHO Standards for improving the Quality of Care for Small and Sick Newborns in Health Facilities and the WHO Standards for Improving the Quality of Care for children and Young Adolescents in Health Facilities.
The standards are built on the WHO framework for improving the quality of paediatric care and the quality of care for small and sick newborns, which has eight domains that target to achieve the desired individual and facility outcomes. The eight domains define eight categories of Standards. Kenya added a ninth standard that covers community newborn and child health care services. In addition to the standards of care, core indicators to track quality of care for children including small and sick newborns in health facilities have been developed. The indicators will be incorporated into the Kenya Quality Model for Health (KQMH). A health facility quality of care assessment tool, which will be used to operationalize the standards, has also been developed.
It is envisioned that all individuals and institutions providing services to children including small and sick newborns will use these standards to improve the quality of care offered to all children including sick and small newborns to ultimately reduce neonatal und under five mortalities in Kenya.
The standards will also provide a resource for policy-makers, healthcare professionals, health service planners, programme managers, regulators, professional bodies, and technical partners involved in care, to help plan, deliver, and ensure the quality of health services among the children.