Postnatal Care in Kenya
Postnatal care in Kenya lacks proper recognition, however, it is rapidly changing. When it comes to looking after newborn babies and their mothers, the right type of postnatal care is crucial to assure wellbeing. According to the Maternal Health Task Force, more than 60% of the world’s maternal deaths occur during the postnatal period, which is about six weeks after delivery. However, the International Journal of Africa Nursing Sciences reports that this period is the most ignored aspect of maternal care globally. Because of the lack of global acknowledgment, countries suffering from widespread poverty have an even harder time implementing postnatal care policies.

Postnatal Care in Kenya

Kenya tried setting up plans for assistance in the past decades with little success. In 2005, the Ministry of Health in Kenya implemented guidelines increasing the way in which it assesses childcare during the postnatal period. Even though about 80% of the country’s hospitals offer postnatal care, only 42% of Kenyan women give birth in a healthcare facility. This leads to high unreported maternal mortality rates in Kenya. In sub-Saharan Africa, every woman has a one in 16 chance of dying during pregnancy or childbirth.

In order to improve this aspect of the maternal care system, multiple approaches have been proposed as potential solutions to advancing postnatal care in Kenya.

Community-Based Care

Because of these facts, Community Health Workers (CHW) are starting to play a crucial role in healthcare. CHWs can reduce maternal deaths and improve the delivery of healthcare services. Unlike hospitals, CHWs are normally the first point of intersection between the healthcare system and communities. They have more access to mothers who may not be able to afford a hospital birth and can provide them with postnatal care.

Communities select the workers who then serve to give home-based counseling and care services. Because they are well-trained at recognizing diseases, CHWs are held in high regard and receive significant respect in health-related manners. This gives the community the knowledge to know to demand better health services. Additionally, these community workers help link citizens to higher-tier resources.

Better Midwives

In at-home births, midwives are key to ensuring that the whole process occurs smoothly. The Journal of Africa Nursing Sciences states that there should be improved and more professional midwife selections.  There should also be supervision of midwives by supportive initiatives in order to ensure qualifications.

These initiatives support work at all levels of postnatal care while providing midwives with positive encouragement. Strong human resources are also necessary for effectively employing these midwives and securing an improved quality of maternal and neonatal care.

Looking Forward

Access to good postnatal care relates to many broad social issues such as poverty and gender equality. However, many are working for advances in postnatal care in Kenya, laying down the plans to make sure maternal services improve. Hopefully, this will lead to healthier children and fewer deaths during childbirth.

– Jack Parry
Photo: Flickr

Maternal Mortality Rates
In Zambia and Uganda, Saving Mothers, Giving Life is a public-private partnership founded by the USAID and put into action by former Secretary of State Hilary Clinton in 2012. Saving Mothers, Giving Life has been a key factor in reducing the overwhelming, preventable problem of maternal mortality rates in Zambia and Uganda. The maternal mortality rates in these countries are some of the highest in the world but thankfully, these rates have declined since 2007.

The Zambia Demographic and Health Survey (ZDHS) reported that maternal mortality rates were around 591 deaths for every 100,000 live births, and neonatal mortality rates were around 34 deaths for every 1000 births.

Many of the causes for these maternal deaths stem from a lack of knowledgeable midwives, a scarce quantity of necessary equipment, poor referral systems and precarious accessibility to lifesaving care.

For example, USAID’s Senior Maternal and Newborn Health Advisor and the U.S. Government lead for Saving Mothers, Giving Life Claudia Morrissey Conlon states that “the nearest hospital [for most Zambian citizens] is 60 kilometers away—40 of them over a rough gravel road. Lacking a cell tower, health center staff would walk or ride 27 kilometers in order to call for an ambulance.

Saving Mothers, Giving Life strives to reduce maternal mortality and neonatal deaths by improving local health systems at a district level, and adding trained midwives who can deliver babies and simultaneously treat the complications that can occur during the delicate process of childbirth.

This preventative initiative was originally launched in four of Uganda’s and Zambia’s districts and has procured tremendous results in both countries. Both Uganda and Zambia saw their maternal mortality rates decrease by thirty-five percent in just one calendar year.

This quick and inspiring statistical turn allowed the program to heavily expand in 2014, adding twelve more districts in Zambia and six in Uganda. The 2015 mid-initiative report stated that “maternal deaths have decreased by 41 percent—not just among women who delivered in a facility, but among the districts’ entire population.”

Saving Mothers, Giving Life allowed the Kabarole District in Zambia to create a Demand Creation Committee that informs women on the advantages of delivering their babies in established health facilities.

The Kabarole District uses its health facilities and local radio stations to educate the public on family planning and prenatal care visits. Thanks to these additional efforts that have allowed local organizations’ to combine forces, “nearly 90 percent of women are now giving birth in a facility, compared to 63 percent at the outset of the initiative.”

Saving Mothers, Giving Life has been so incredibly successful since the program’s implementation in 2012 that the initiative has changed many societal norms regarding childbirth in these countries. The initiative is already expanding to countries like Nigeria and serves as a model for other countries to follow suit.

Since Saving Mothers, Giving Life can be sustained for the long term, countries are gaining the tools to be able to take care of themselves and effectively treat the many problems that can occur during childbirth.

Such capabilities are extremely pertinent if countries like Uganda, Zambia and Nigeria want to become self-sustaining. These countries have made extraordinary strides in healthcare and as a result, their future looks more promising than ever.

Terry J. Halloran

Photo: Flickr

vaginal_ringThe World Health Organization has included the progesterone contraceptive vaginal ring (CVR) on its 2015 Essential Medicines List.

Developed by the Population Council, this contraception method is unique because it is safe and effective for lactating women after they have given birth. It can be used as early as four weeks after childbirth for up to one year in order to space out potential future births.

Birth spacing is important for the health of mother and child. Maternal death and other health complications are more likely to arise with short intervals between births. In addition, family planning can help parents to plan finances related to family expansion. Family planning is critical to poverty reduction. When families do not have the knowledge or ability to space births, particularly in developing countries, they may also lack the resources to support these children.

The vaginal ring is 98.5 percent effective in preventing pregnancy with proper use. The ring can be inserted and removed by the mother. This translates to less doctor visits, which are known to strain family resources, such as time and money, in developing countries.

The ring releases progesterone, but does not interfere with breast milk production. In this way, it is unlike oral contraceptives, which contain estrogen and cannot be used by lactating women.

This method is currently used in Bolivia, Chile, Dominican Republic, Ecuador, El Salvador, Guatemala, Panama, and Peru. Currently, studies in India and Sub-Saharan Africa are underway in order to determine if it could be effective in these regions as well.

The inclusion of this method on the list from the World Health Organization’s list suggests that it is likely to be more accessible to communities in the near future. The CVR is effective, safe, and inexpensive. Medical services can be difficult to reach in developing countries, but the CVR places very few demands on doctors.

The Population Council is currently developing another vaginal ring that will not have to be replaced every 3 months. It would last for one year. This would make this contraceptive method even more appropriate for the developing world.

In the future, we may even see vaginal rings that can protect against HIV and other sexually transmitted diseases, in addition to its contraceptive function. This exciting new technology has the potential to address many of the global health problems our world faces today.

Iliana Lang

Sources: WHO, Population Council, Impatient Optimists
Photo: Impatient Optimists

During an orientation on women’s maternal health, The Target States High Impact Project (TSHIP), a non-government organization funded by USAID, released its findings that Eclampsia is the cause of 80% of deaths that occur during childbirth in Nigeria.

Eclampsia is a condition when the infected woman experiences extreme bleeding while giving birth. Pregnant women suffering from Eclampia will experience chest pains, convulsions, seizures, and hallucinations. The disease then attacks all of her multiorgans like the brain, lungs, livier, and chest.

The good news is that Eclampsia can be cured if the infected woman is treated in time. Testing urine samples and changes in blood pressuring during pregnancy can identify the disease before the woman goes into labor. Once Eclampsia is detected, it can be treated with Magnesium Sulphate, an injection that brings the woman back to consciousness while she is in labor. The best way to ensure a safe birth is by going to a doctor once labor begins.

Dr. Habib Sadauki, TSHIP Deputy Chief of Party Maternal, warned women of the dangers of giving birth at home. When having a home birth and severe bleeding occurs, the woman is at high risk of dying during labor. If pregnant women would “seek adequate antenatal services” when they are in labor, maternal deaths could be reduced by 70%.

At the conference, Dr. Sadauki explained how malaria and anemia are the other two main causes of deaths during pregnancies. Once again, he urges women to seek medical attention and also to sleep in insecticide-treated mosquito nets. Childbirth can a very dangerous time for the mother and child and Dr. Sadauki hopes that pregnant women will seek medical attention to prevent possible disease and death.

– Mary Penn

Source: Vanguard
Photo: School Work Helper