Bridging Data Gaps: Predicting Sub-national Maternal Mortality Rates in Kenya Using Machine Learning Models

Introduction Maternal mortality remains a critical global health issue, with ongoing efforts to reduce its incidence as part of international health priorities. Kenya, a sub-Saharan country that has a disproportionate number of maternal mortality is likely to miss this target unless evidence-based interventions are deployed. The paucity of reliable maternal health data calls for the development of alternative predictive models to complement the impaired civil registration system and the aperiodic national surveys. Methods We utilized DHS surveys from several Sub-Saharan African countries to estimate parameters for predicting Kenya's maternal mortality rate (MMR) in the absence of recent Kenya Demographic and Health Survey (KDHS) data. We developed a multiple linear regression model using supervised machine learning using the R-programming suite. Our model leverages machine learning techniques to analyze regional trends and predict sub-national MMR variations. We then applied the model to predict MMR for Kenyan counties using the data for the KDHS 2022 survey.  Results Using Pearson's correlation, we observed a significant positive correlation between MMR and total fertility (r = 0.32, p = 0.025) and a significant negative correlation between MMR and maternal age at first birth (r = -0.40, p = 0.005). Additionally, a significant correlation was observed with the cumulative percentage of mothers attending post-natal clinics, the prevalence of thinness (r = 0.77, p < 0.001), HIV infection in women (r = 0.20, p = 0.164), and physical violence during pregnancy. The model estimate of national MMR in 2022 was 367 deaths per 100,000 live births, ranging from 49 deaths per 100,000 live births in Kisii County to 1794 deaths per 100,000 live births in Turkana County. Conclusion Although MMR in Kenya displayed a general downward trend, our model's estimates for DHS 2022 indicate an increase compared to the 2019 National Census and Housing Survey estimate of 355 deaths per 100,000 live births. This rise may be attributed to COVID-19-related maternal deaths during the same period. The integration of predictive models to inform interventions and resource allocation could play a crucial role in enhancing maternal healthcare outcomes in Kenya.