County’s push to curb infant and maternal deaths pays off

Maternity nurses at Lodwar County Referral Hospital display how squat birth is professionally done. The county government was forced to innovate for special squatting stools to encourage women give birth in hospital after they shunned health facilities for fear of delivering on beds. [Peter Ochieng, Standard]
Did you know delivering while squatting gives a woman enough pressure to push the baby out as compared to lying on a bed? 

Ms Anne Adung says this is a common practice within the Turkana community that disregards women giving birth while lying on their back.

“Since time immemorial, Turkana women give birth while squatting, a practice which has been passed from one generation to the other. Hospitals were also set in faraway areas making many women prefer home deliveries,” she says.

Delivering while squatting or kneeling she says saves a woman from using a lot of energy and going into long labour. In its bid to embrace the culture, Turkana County government has introduced squatting stools in most of its health facilities.

“My three children were all delivered at home, save for my last born who was born in hospital. While in hospital on the delivery bed, it took me long to deliver until I asked to be taken to the squatting stool,” says the 38-year-old woman.

At least 75 per cent of women who gave birth in 2016 in Turkana preferred home deliveries assisted by a relative and traditional birth attendants, while others gave birth without any help.

Giving birth without an attendant can jeopardise lives of both mother and infant in case of any complications. According to the National Council for Population and Development-2015 report, Turkana ranked third with 1,594 maternal deaths per 100,000 live births. Infant mortality was also 140 deaths per 1000 live births.

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The worrying statistics forced the area government back to the drawing board after it was found that their counterparts - Karamoja on the neighbouring Ugandan border, had low mortality rate.

Ms Alice Ekiru says that apart from making delivery easy and less painful, squatting offers women privacy.

“Majority of mothers who deliver at health facilities use the squatting stool (a long stool with a curved upper part fitted with a cushion) and take about 10 minutes to give birth on the soft and comfortable cushion,” says Ekiru who delivered all her five children at home.

Lodwar County Referral Hospital Director Stephen Namoru Ekitela said Karamoja state health facilities are providing women with birth stools.

The medic said the Karamoja practice of providing squatting stools in hospital has been adopted to reverse the favoured home delivery trend by attracting women to deliver in health facilities with the help of skilled personnel. “It is barely four years and we are making remarkable strides in reversing both maternal and infant mortality in the region.

Hospital deliveries increased from 33 per cent in 2016 to 65 per cent,” said Dr Ekitela. “At the hospital, there is an average of 350 deliveries per month compared to 150 in 2016. The same is replicated at sub-county hospitals spread across the region."

Turkana Governor Josphat Nanok said the referral hospital now rivals private health facilities since it has been fitted with modern equipment for dialysis, theatre, maternity, CT Scan, dental and HDU. “Skilled delivery has improved, reducing infant and maternal deaths; we have also increased the number of doctors,” he said.

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Infant deathsTurkana communityLodwar County Referral Hospital