Double Blessings: Kilifi Improves Maternal Health Services

Rehema Karisa, 29, smiles softly at her twins, who are wrapped in delicate pink and calming blue shawls, born two days ago at the Kilifi County Referral Hospital. Rehema delivered here after she was referred from a smaller hospital.

Rehema radiates a broad smile that conveys exhaustion, relief and quiet joy as she admires Bright, the girl, and her brother, Brighton.

Her eyes are filled with gratitude and determination. As per the National 2019 Census, Kilifi County had a high maternal mortality rate of 532 per 100,000 live births as compared to the National average of 355 per 100,000 live births.

The safe delivery of these two healthy babies indicates that maternal healthcare in Kilifi County is improving, with necessary steps being taken following concerningly poor health indicators over the previous five years.  

Dr Laura Oyiengo, UNICEF Kenya’s Maternal and Newborn Health Specialist, outlines that the response to this worrying trend has been a campaign to encourage pregnant mothers to seek skilled healthcare, despite the vast distances between households and health facilities. 

"In Kenya, about 5,000 pregnant women and 30,000 newborn babies die annually, mainly due to preventable causes: excessive bleeding, high blood pressure, and infections for pregnant women; prematurity, birth asphyxia and infections in newborns,” said Dr Laura.

Kilifi County now has four newborn units situated across the sub-counties, bringing newborn health services closer to the communities. A maternal and newborn health acceleration plan has addressed bottlenecks in health care, provided medical devices and training equipment to establish a learning hub, all aimed at enhancing maternal and newborn health services.

Successful strategies for reducing maternal and newborn deaths include having at least eight antenatal care visits and contacts during pregnancy. This should include an antenatal ultrasound, and pregnant women with complications must be linked to high-risk clinics and diligently followed up to monitor the progress of the pregnancy.

Essential newborn care plans for all babies include the baby being kept warm and where breastfeeding starts as soon as possible after delivery. Newborn units that promote Kangaroo mother care for preterm babies, management of respiratory infections and care for birth trauma are also crucial.

"With the devolution of health services to the county governments, significant strides have been made. The County Government of Kilifi has built and equipped their health facilities with a modern medical complex. With UNICEF support, healthcare workers have been trained on high-impact maternal and newborn health interventions, enhancing their skills to deliver quality healthcare services," continued  Dr Laura.

Kenneth Miriti, Reproductive Health Coordinator for Kilifi County, noted that UNICEF’s health workers' training offers a practical, skills-based approach and mentorship, ensuring better retention of knowledge and improved service delivery.

"We work together to ensure that there are no lives lost from preventable and manageable causes," said Mr Miriti. Under the programme, UNICEF has provided training for 90 health workers on quality healthcare services to mothers and their newborns.

"Training on essential services such as emergency obstetric care has significantly increased healthcare workers’ motivation, improved the health of mothers and babies and instilled greater confidence, ultimately encouraging more mothers to seek skilled care in the health facilities," said Mr. Miriti.

With funding from the Church of Jesus Christ of Latter-day Saints, maternal and newborn health learning hubs at Nairobi’s Pumwani Maternity Referral Hospital and Kilifi County Referral Hospital, represent an innovation in building capacity for healthcare workers. The hubs shift away from traditional classroom lecture training toward skills-based training, incorporating real-life practical sessions at hospital maternity and newborn units.

Dr Laura added that the health workers have also greatly improved communication between patients and health providers. They add a personal touch while providing high-quality health services that are respectful, sensitive and responsive to the needs of mothers and babies.

"Since the training, healthcare providers can now support women in delivering with various birthing positions, offering a range of options as part of respectful maternal care. The health workers are now better prepared to handle emergency obstetric and newborn conditions, preventing potential deaths of mothers and infants," she explains.

After delivery, mothers are offered essential information about their wellbeing, care for their babies and danger signs that could signal a need to return to the hospital for review.

Community health promoters are linked to each mother and conduct follow-up checks, assessing key health indicators and making referrals accordingly.

"The community health promoters play a vital role in referring pregnant or lactating women and newborns showing danger signs to health facilities for timely treatment and management," added Dr Laura.

Rehema feels confident about going home. "I have received exceptional health care at this hospital since admission. I'm grateful for the newborn care, immunization information, breastfeeding tips, and comprehensive newborn care information received on how to care for my newborns as we head home," she said.

As she takes the newborns home to meet their siblings and the wider extended family members, Rehema looks ahead with hope, ready to embrace the challenges and joys of motherhood with her little ones safely in her arms.