The County Government of Nakuru is strengthening hands on training for surgical teams from 10 public facilities involved in Caesarean Section and other obstetric procedures, aimed at improving maternal and newborn outcomes.
Through the ongoing Obstetric Safe Surgery (OSS) Programme, the healthcare facilities are being equipped with advanced simulation models, including Caesarean Section (CS) birth models, complete CS procedure sets, and other training equipment designed to support continuous learning, mentorship, and hands-on practice.
The County Executive Committee Member (CECM) for Health Care Services Roselyn Mungai said the department was focused on safe obstetric surgery, adding that the equipment will help standardize obstetric surgical skills across the county, ensuring healthcare workers can safely practice life-saving procedures in simulated environments before applying them in clinical settings.
She said the surgical teams were undergoing a specialized training supported by Jhpiego Johns Hopkins Programme for International Education in Gynecology and Obstetrics and facilitated by experts from the Global Surgery Foundation (GSF) and AIC Kijabe Hospital.
While noting that the training was crucial for maintaining high standards of surgical practice and keeping up with advancements in medical technology, Mungai pointed out that the initiative was enhancing technical and non-technical skills of the surgical teams, promoting patient safety, and fostering effective teamwork.
The programme, which began in five hospitals during its first phase was now expanding to ten health facilities across the 11 Sub Counties, with each facility set to receive the simulation equipment alongside continued capacity building and clinical mentorship.
“The expansion demonstrates the commitment of Governor Susan Kihika’s administration to sustaining quality improvements in maternal healthcare beyond classroom training,” the CECM added.
Speaking when she received the simulation models at the Nakuru County Teaching and Referral Hospital (NCTRH), Mungai explained that the training features simulation-based learning and practical sessions aligned with World Health Organization (WHO) global guidelines for preventing surgical site infections.
This approach, she added, ensures consistent application of best practices across all the county health facilities.
The CECM said the initiative was part of a broader effort to strengthen the efficiency of Nakuru’s surgical workforce and by enhancing surgical capacity and skills, even the County intends to significantly reduce preventable maternal deaths and improve outcomes of cesarean deliveries.
The training was also focusing on utilizing the World Health Organization’s (WHO) Surgical Safety Checklist and adhering to infection prevention measures, in addition to addressing concerns about maternal and newborn safety during childbirth.
Mungai was happy that the support from partners was beyond equipment, adding that the initiative was an investment in the competence of the County healthcare workers and the safety of mothers and newborns.
She said the partners were complementing the investments in human resources and continuous training where the simulation models would help sustain quality improvements in obstetric care across the county.
She indicated that the training programme involves a team-based approach, focusing on enhancing communication and teamwork among surgical staff and would cover a range of obstetric surgical procedures, including Cesarean sections, assisted vaginal deliveries and other critical interventions.
The CECM affirmed that a significant emphasis was being placed on safety in the operating theater, including the proper use of surgical equipment and adherence to safety protocols, as this will contribute to a stronger, more skilled surgical workforce, ultimately leading to improved maternal and newborn health.
Mungai emphasized the importance of upholding professional standards in surgical practices, adding that there is a need to enhance surgical training programmes to ensure that practitioners are equipped with the necessary skills to handle various surgical procedures.
Jhpiego, known as the John Hopkins Programme for International Education in Gynecology and Obstetrics, is a non-profit international health organization affiliated with Johns Hopkins University.
Founded in 1973, Jhpiego focuses on developing and implementing effective, low-cost solutions to strengthen healthcare delivery for women and families globally.
It works to improve maternal and newborn health, family planning, HIV/AIDS prevention and treatment, and other critical areas of women’s health. Its work also includes developing training materials, strengthening health systems, providing technical assistance, and advocating for policy changes to improve health outcomes.
Jhpiego operates in numerous countries across Africa, Asia and America, adapting its programmes to address specific local needs and challenges. It partners with governments, health experts, and local communities to build health providers’ skills and develop systems that ensure access to high-quality care.
Mungai disclosed that the training programme is incorporating technology, such as virtual reality and video-based learning, to provide the surgical teams with immersive and realistic experiences.
The CECM noted that surgical teams required sufficient hands-on experience in operating rooms to develop the necessary skills and confidence, which could be affected by factors like limited theatre access and service delivery pressures.
The training initiative, she said, is geared towards improving patient safety by ensuring that surgical teams are well-prepared and competent in handling various surgical scenarios.
The CECM noted that obstetric and gynecological surgery requires specialized training, continuous competency assessments, and strict adherence to globally accepted medical and surgical safety standards.
She urged stakeholders in the medical sector to uphold professional standards, strengthen surgical training programmes, enhance oversight and regulation, and engage in meaningful consultations to ensure patient safety.
“The County Department of Health Care Services is subject to medical ethics and professional standards. Our duty and responsibility are to ensure that every Kenyan receives quality healthcare that aligns with best medical practices, established legal frameworks, and global patient safety guidelines,” affirmed Mungai.
She regretted that complications during childbirth remained a leading cause of maternal deaths, and that the training was crucial for improving outcomes, adding that obstetric and gynecological surgeries required specialized training and competency assessments.
The training also includes post-discharge surveillance protocols, such as follow-up calls and visits, to monitor patients’ recovery and identify any potential issues.
Mungai also commended the OSS implementation team for developing a performance tracking dashboard after her call for stronger programme monitoring.
The dashboard is expected to help the county track progress across participating facilities, support data-driven decisions and improve accountability in maternity care.
The World Health Organization (WHO) has developed guidelines for surgical procedures, including those for obstetric and gynecological cases, to improve safety and reduce complications.
The county’s 2025 Health Sector Report shows Nakuru has 515 maternal and newborn care facilities, 284 Basic Emergency Obstetric and Newborn Care facilities and 56 Comprehensive Emergency Obstetric and Newborn Care facilities, which include surgeries and transfusions.
The report also says the county trained 88 service providers in Emergency Obstetrics and Newborn Care and introduced heat-stable Carbetocin to help prevent postpartum haemorrhage, which remains a major cause of maternal deaths.
The Nakuru OSS project was launched in March 2025 to improve safe, timely and respectful Caesarean Section care for more than 25,000 women giving birth each year in Nakuru County.
According to Jhpiego the Nakuru project employs a hub-and-spoke model to strengthen surgical teams, referral networks and data systems, with a target of improving access to safe Caesarean care for nearly 21,000 procedures over three years.
The first phase covered five facilities: Nakuru Provincial Hospital as the hub, and Naivasha District Hospital, Bahati District Hospital, Molo Subcounty Hospital and Gilgil Subcounty Hospital as spokes. The project provides continued training and mentorship for obstetricians, surgeons, anaesthesia providers, nurses, midwives and theatre staff.
The intervention targets a major gap in maternal care. The Global Surgery Foundation says 37 percent of maternal deaths in Kenya are associated with Caesarean Section, while Nakuru’s Caesarean Section rate stands at 22.9 percent across the project facilities.
National data also shows the scale of the challenge. The 2022 Kenya Demographic and Health Survey placed neonatal mortality at 21 deaths per 1,000 live births, infant mortality at 32 deaths per 1,000 live births and under-five mortality at 41 deaths per 1,000 live births.
Maternal mortality estimates for Kenya remain above 350 deaths per 100,000 live births, far above the Sustainable Development Goal target of 70 deaths per 100,000 live births by 2030.
In Nakuru, the county health report shows skilled delivery performance remains below target. Deliveries conducted by skilled attendants stood at 75 percent in 2024/25 against a planned target of 90 percent, with the county citing continued household identification and referral by Community Health Promoters.
The report further identifies staff shortages, demand for blood and blood products, and inadequate skills in midwifery, obstetrics and Emergency Obstetric and Newborn Care as continuing challenges in maternal and neonatal services.
By Esther Mwangi and Caroline Nyakio
