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In Kenya, maternal shelters are part of a broad package of care designed to reduce child mortality

By Pamella Sittoni

Worldwide, under-5 mortality has declined from more than 12 million deaths in 1990 to 7.6 million in 2010 – yet thousands of children still die every day from preventable diseases. On 14-15 June 2012, the Governments of Ethiopia, India and the United States, together with UNICEF, are convening the Child Survival Call to Action, a meeting to mobilize the world toward one ambitious but simple goal – ending preventable child deaths. This story is part of a series highlighting global efforts to improve child survival.

GARISSA, Kenya, 14 June 2012 – The moment the labour pains set in for Shagaa Issack, the caretaker shifted her full attention to the mother. The caretaker, at the maternal shelter in Kenya’s North Eastern Province, helped Ms. Issack slowly make her way to the Garissa Provincial General Hospital, just 300 metres away.

UNICEF reports on maternal shelters as part of a broad package of care designed to reduce child mortality.  Watch in RealPlayer


There, Ms. Issack’s baby was born by Caesarean section. Her proud husband, Issack Mohamed, marveled at the baby girl, but he was apprehensive about Ms. Issack’s condition. He was right to be concerned; a few hours later, there was pandemonium in the maternity unit as efforts were made to revive her. Fortunately, a blood transfusion blood gave her a new lease of life.

Two days later, as Ms. Issack cuddled their baby, Mr. Mohamed also expressed gratitude to the doctors who made the life-saving decision to refer Ms. Issack to the maternal shelter, which ensured she was regularly monitored and had access to emergency obstetric care.

“The two previous deliveries were difficult. She almost died from excessive bleeding,” said Mr. Mohamed. He was therefore happy to accompany his wife the 800 km to the only maternal shelter in the province, where she stayed for a month before delivery.

Maternal shelters save lives

The maternal shelter is a waiting home where women with high-risk pregnancies stay for monitoring and quick access to the provincial hospital – which saves the lives of both mothers and newborns.

UNICEF supported the establishment of the maternity shelter in Garissa as part of its efforts to focus on ‘high risk’ areas.

© UNICEF Kenya/2012
Doctors perform a Caesarean section on Shagaa Issack at the Graissa Provincial Genral Hospital in Kenya.

“Had my wife not come to the shelter to deliver at this hospital, she could have died,” said Mr. Mohamed.

This remark was echoed by scores of families in the region who had made use of the shelters. After five miscarriages, Hawa Ali Hussein, 25, stayed at the maternal shelter for three months before finally delivering a baby girl. “I used to wake up in the middle of the night and pray to God to give me a child. I am really happy my prayers were answered,” she said.

Dakan Billow, 27, suffers from a disease that has left her disabled. Doctors advised her to stay at the maternal shelter for monitoring. She spent three months at the shelter and is now back home with a healthy baby boy.

Reducing maternal and child mortality

According to Dr. Mohamed Sheikh, the North Eastern Director of Public Health, the region has the country’s highest maternal death rate, more than twice the national average of 488 deaths per every 100,000 live births.

However, he notes that initiatives like the maternal shelter and vouchers encouraging women to deliver at health facilities could go a long way in reducing maternal and child deaths.

© UNICEF Kenya/2012
Shagaa Issack breastfeeds her newborn baby at Garissa Provincial General Hospital in Kenya.

And in recent years, Kenya has recorded significant reduction in child mortality. According to the Kenya Demographic and Health Survey (2008-2009) the country’s under-5 mortality rate reduced from 115 deaths per 1,000 live births in 2003 to 74 in 2008-2009. Infant mortality also dropped from 77 deaths per 1,000 in 2003 to 52 deaths per 1,000 in 2008-2009.

The improvement in child survival is as a result of a combination of strategies and initiatives by the government and partners. These include improvements in immunization levels, increased rate of exclusive breastfeeding for the first six months of a child’s life, improved access to clean water, and improved management of diarrhoea.

In 2007, the Government launched an initiative called Malezi Bora (‘Good Nurturing’) to increase the utilization of routine child survival services, including immunization, growth monitoring and vitamin A supplementation. This Ministry of Health initiative also provided essential supplies and health personnel at government health facilities. This was followed in 2009 by a national Child Survival and Development Strategy aimed at helping the country to achieve the Millennium Development Goal (MDG) on child survival.

The Government has also recently introduced the pneumococcal vaccine to protect children from another leading child killer, pneumonia. And early this year, the government undertook an initiative that ensures that mothers or children visiting health facilities receive a full package of services, including immunization, growth monitoring, HIV counseling and testing, and vitamin A supplementation.

"Reducing maternal and child mortality requires a balanced investment in health systems, including infrastructure, trained and motivated health workers and equipment and supplies, on one side, and creating demand at individual, family and community level on the other,” said UNICEF Chief of Health Ketema Bizuneh.
Now, Kenya is joining the rest of the world in committing ‘Child Survival: A Promise Renewed’, and is amplifying its efforts to reduce child mortality in time for the 2015 MDG deadline.



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