Directorate of Reproductive Health
Primarily based at Riley Mother and Baby Hospital (RMBH), the Directorate of Reproductive Health serves as a Centre of Excellence for both outpatient and inpatient services to expectant mothers requiring obstetrical care—medical and surgical. It uniquely offers the rare sub specialization of Maternal-Fetal Medicine (MFM), catering to women with pregnancy and postpartum medical complications such as pre-eclampsia, diabetes in pregnancy, and cardiac conditions. The MFM unit also provides detailed ultrasounds and prenatal screening procedures for early identification of fetal congenital and genetic abnormalities.
RMBH is equipped with two state-of-the-art obstetrical theatres and fully functional Neonatal Intensive Care Units (NICU)/Newborn Units, ensuring comprehensive care for mothers and infants.
The Directorate also manages a wide range of gynecological conditions, from general gynecology (e.g., fibroids, abnormal uterine bleeding) to gynecological oncology. Services include cervical cancer screening, early diagnosis, and treatment of gynecological cancers such as cervical, uterine, and ovarian cancers, primarily managed in the Faraja Gynecological Ward.
Additionally, the Directorate hosts the Centre for Assault and Recovery – Eldoret Unit, which provides medical care, free legal representation, and, where necessary, shelter placement for young girls and women who are survivors of sexual and gender-based violence. It also caters from mother who are infected with HIV and takes care of the HIV exposed infants (HEI)
Organizational Structure
The Directorate comprises three departments:
- Obstetrics and Maternal-Fetal Medicine
- General Gynecology
- Gynecological Oncology
It also functions as a training hub for fellows in Gyn-Oncology and Maternal-Fetal Medicine, medical students (undergraduate and postgraduate), nursing students, and other allied health professionals.
Referral and Service Capacity
As the main tertiary referral hospital for 22 counties in Western Kenya, the Directorate is equipped with emergency theatre capabilities, ICU, CCU, dialysis services, and a multidisciplinary team including consultant anesthetists, critical care specialists, obstetrician-gynecologists, maternal-fetal medicine specialists, and gyn-oncologists.
- Annual Deliveries: ~10,000
- Emergency Cesarean Sections: ~2,700 (C-section rate: 27%)
- Gynecological Procedures: ~60 per month (emergency and elective)
The Directorate of Reproductive Health offers the following Services
General Obstetrics
- Routine Antenatal and Postnatal Care information
- Prenatal Care Antenatal Screening/
- General Obstetrics Ultrasonography
- High-Risk Pregnancy Management
- Labor Monitoring and Delivery/ Childbirth
- PMTCT and HIV Exposed Infants (HEI) Services
General Gynecology
- General Reproductive Health Care Education
- Managements of early pregnancy complication including miscarriages,
- Routine HealthCare information
- PAP Smears for Cervical Cancer Screening
- Breast Exam
- Contraceptive Counseling
- Management of Menstrual Disorders
- Treatment of STIs
- Fertility Evaluation and Referral
- Management of Menopausal Symptoms
- Screening of Gynecologic Cancers
- Colposcopy
- Biopsy procedures
Surgical Procedures
- Hysterectomies,
- Laparoscopic Surgeries,
- Removal of Ovarian cysts,
- Removal of Uterine fibroids,
Super/Sub Specialization
- Maternal Fetal Medicine
- Prenatal Diagnosis of Chromosomal and Congenital Disorders.
- Level 2 Obstetrics anatomy scan
- Management of Medical Disorders of Pregnancy: hypertensive disease of Pregnancy, Cardiac Disorders, Diabetes in Pregnancy, thyroid disorders in Pregnancy, Recurrent Pregnancy Loss
- Management of multiple Pregnancies
- Fetal Therapy: Amnioreduction, Intra-uterine Fetal Transfusion, Fetal reduction
- Gynae- Oncology
- Diagnosis and Management of Gynecological Cancers (
Cervical Cancer, Ovarian Cancer, Endometrial Cancer, Gestational Trophoblastic Disease)
- Administration of Chemotherapy and Radiation of Gynecologic Cancers
Surgical Procedures
- Wertheim’s Hysterectomy
- Ovarian Cancer Re-section
- Simple and Radical Vulvectomy
- Urogynecology
- Treatment for urinary incontinence and Pelvic organ prolapse
Surgical Procedures
- Repair of vesicovaginal and Rectovaginal Fistula
- Repair of Pelvic Organ Prolapse
- Adolescent Gynecology
- Education on Puberty & Reproductive Health,
- Management of Menstrual Development Issues in Adolescents.
- Minimally Invasive surgeries
Surgical Procedures
- Laparoscopic Hysterectomies,
- Laparoscopic Removal of Ovarian cysts, Ectopic Pregnancies
- Removal of Uterine fibroids,
Outpatient Services
The Directorate provides a wide range of outpatient services, including:
| Clinic | Days Offered | Time |
| Routine Antenatal Clinic | Monday to Friday | 8.00am – 5.00pm |
| Well Baby Clinic | Monday to Friday | 8.00am – 5.00pm |
| Family Planning/ Contraception | Monday to Friday | 8.00am – 5.00pm |
| Cervical Cancer Screening | Monday to Friday | 8.00am – 5.00pm |
| High Risk Antenatal Clinic | Every Monday | 8.00am – 5.00pm |
| Maternal Fetal Medicine Clinic | Every Thursday | 8.00am – 5.00pm |
| Gynecology Outpatient clinic | Every Tuesday and Wednesday | 8.00am – 5.00pm |
| Reproductive Endocrinology and Infertility (REI) Clinic | Second and Last Tuesday of the Month | 8.00am – 5.00pm |
| Urogynecology Clinic | First Friday of the Month | 8.00am – 5.00pm |
| Pediatric and Adolescent clinic | Second and Fourth Friday of the Month | 8.00am – 5.00pm |
| Postnatal Clinic | Every Friday | 8.00am – 5.00pm |