Kenya’s fertility rate has declined from 3.4 to 3.1 children per woman, according to the government’s 2025/26 Kenya Mini Demographic and Health Survey. The findings reveal significant differences in reproductive patterns by education, household wealth, and place of residence. Rural women have an average of 3.6 children, compared with 2.6 among urban women, while women without formal education have 5.4 children, compared with 2.7 among those with secondary education. Fertility also varies across counties, with Mandera recording the highest rate at 6.8 children per woman and Embu the lowest at 2.2. Overall, 31 of Kenya’s 47 counties have fertility rates above the national average.  

The survey further indicates that the median interval between births has increased from 43.1 months in 2022 to 48.3 months in 2025/26, reflecting longer spacing between pregnancies. Birth rates are highest among women aged 25–29, at 161 births per 1,000 women, while teenage fertility among those aged 15–19 stands at 63 per 1,000. Despite the decline in fertility, maternal mortality remains a public health concern. The maternal mortality ratio has improved to 263 deaths per 100,000 live births, down from 362 in the 2022 survey and 520 in 2003. Medical Services Principal Secretary Ouma Oluga said the government is targeting a reduction to 70 or fewer deaths per 100,000 live births, in line with the global Sustainable Development Goal target.  

Access to maternal healthcare has also improved, with facility-based deliveries rising from 88 per cent to 91 per cent. By comparison, the proportion of women attending at least four antenatal care visits rose from 66 per cent to 72 per cent. Early antenatal attendance in the first three months of pregnancy increased from 29 per cent to 36 per cent, although only 9.5 per cent of women completed the recommended eight antenatal care contacts. The survey also recorded an increase in Caesarean deliveries, from four per cent in 2003 to 20 per cent in 2025/26, while modern contraceptive use stands at 56 per cent. Regional disparities remain evident, with facility-based deliveries ranging from 47 per cent in Garissa to 100 per cent in Nairobi, Nyandarua and Nyeri.