Better births, better care for Kenya's new mothers
17 March, 2009
Related pages:
Kenya country homepage
Twenty-four year old Mary Atieno (pictured left) is expecting to give birth at the Magunga Health Centre, just around Mother’s Day.
Childbirth was something that Mary used to fear. She had her first baby at home in Gwassi (Nyanza province, Western Kenya) when she was 18. Giving birth here used to be expensive – expectant mothers had to pay the 'granny' (or 'dani'), the untrained traditional helper, to assist them through the birth. Typically mothers like Mary would be charged 1000 shillings (£9) to help them deliver.
Mary used a traditional helper, and ran into problems after the delivery. She started to bleed. "The following day my husband took me to Magunga hospital – we had to walk for over an hour. I was so weak and dizzy I was sure I was going to die.
"But they gave me new blood by transfusion and I was all right. I decided then that my next baby would be delivered in the hospital. Not by the dani." More on Mother's Day in Kenya
Here in Nyanza, district there is a frighteningly high likelihood of a woman dying in childbirth. DFID's involvement here was to support Magunga's health centre in improving maternal and newborn health services, training health workers, paying for medical equipment and helping to raise awareness of these services in the community.
Since March 2008, the numbers of mothers giving birth at the Magunga health centre has more than doubled, from five a month two years ago to 13. Dozens of women come for post and ante-natal classes.
"Full to Bursting"
"Now,
because of the training and education, most women want to give birth here, not
at home," says Dr Hillary Kiptoo (pictured left), the clinical officer in
charge of the centre. "And we’re full to bursting."
Judith Awuma, 22, is currently attending the Health Centre's post-natal class, with six week old baby, Joseph. She said: "We came to hospital because we know its safer – my grandmother wanted me to stay in the village, but I said no.
"You can be helped in the hospital if there are complications. It was my first pregnancy, and I wanted everything to go right."
Midwife Doreen Nalianya has worked here for three years and she’s proud that the health centre has become so popular (watch Doreen in action in our YouTube video).
"In the past mothers were frightened of giving birth here. They thought if you came here you were likely to die – because often the health centre only saw women when they were already having problems with their labour. They thought they would have to pay.
"But we’ve changed all that – and now the village traditional midwives send their clients to us."
So, demand is high. But the health centre is has just one ward and half a dozen other rooms under a tin roof. Electricity and water supplies are unreliable. The next step? A bigger, better-equipped is badly needed, so DFID is paying for a new maternity unit, which will be open by summer 2009.
Julia Bunting, DFID adviser on maternal health said:
"The impact of a maternal death on families and communities is devastating – but is especially so for surviving children. A newborn baby is three to ten times more likely to die within its first two years without its mother."
Mother's Day in Western Kenya
What
Mary is looking forward to most, with this third child, is not cards or flowers
– they’re not really a tradition here in remote rural Kenya. She's looking
forward to a feast.
"Chicken, beef and chapattis!" she says. "Don’t you know a woman eats like a hyena when she’s had a baby?"
She’s excited because meat is a rare luxury here. A normal evening meal for her, husband Noah and their two children is ugali, a stodgy porridge made from corn flour, fried greens and onion. Once or twice a week they might get some fish from nearby Lake Victoria.
It’s a strong belief here that a new mother must be well-fed, to help her regain her strength and breast-feed the baby: a lot of the household budget is devoted to this.
"Having a baby is a wonderful thing, because it brings smiles and peaceful hearts to the family," says Mary, with a smile. "My husband loves me and everyone is pleased. Especially my husband’s mother."
Key Facts
- In Kenya, the number of women dying in childbirth is 560 per 100,000 live births (the ratio rises to between 560 to 1,000 in some parts of Nyanza). In the UK it is 8 per 100,000
- Nyanza province has one of the worst indicator of maternal health in Kenya and contributes to 25% of Kenya's maternal deaths
- DFID's Essential Health Services programme is supporting targeted health facilities - including Magunga Health Centre - in Nynaza province. It aims to improve maternal and newborn health services through the training of health workers, provision of essential medical equipment, and raising the profile of those services in the community
- Total project spend to date is £7.2m of which about £5.1m has been spent in Nayanza (about 70%), mostly on rehabilitation and upgrading of health centres. Health workers have also been trained on delivery, community mobilisation and organisation to demand for services have been conducted in addition to piloting of referral system using motorcycle
- Since the programme started the deliveries by skilled attendants has increased from approximately 18% to 23% in the target districts. To date 93 health workers have trained in emergency obstetric and neonatal care
- Having a husband present is surprisingly important to many of the women. In most African societies a husband keeps away from the labour room, but DFID-funded training and pre-natal education here has encouraged mothers to believe that a husband’s involvement is important
- Currently around 50% of DFID Kenya’s aid (£50m in 2007/8) is allocated to health and HIV/AIDS , focusing on health systems, malaria, reproductive health and strengthening the delivery of essential health services.
