Nyanza steps up fight against newborn deaths as preterm babies face care gaps

Tessie Musalia Mudavadi, spouse to Prime Cabinet Secretary Musalia Mudavadi with Migori County First Lady Agnes Ayacko and Kisumu County First Lady Dorothy Nyong’o during the handover of 11 neonatal incubators under the Okoa Malaika programme at Lumumba Sub-County Hospital in Kisumu.[ Rodgers Otiso ]

For mothers whose babies arrive too soon, the joy of childbirth can quickly turn into days of fear as they watch their tiny newborns fight for survival. At Lumumba Sub-County Hospital in Kisumu mothers of preterm babies joined health workers and county officials as neonatal incubators were handed over to six counties, highlighting the need to close equipment gaps in the care of vulnerable newborns.

The handover came as health officials raised concern over the slow progress in reducing deaths during the first 28 days of life, with premature babies facing some of the greatest risks.

Speaking during the handover of the equipment under the Okoa Malaika programme, spouse to Prime Cabinet Secretary Musalia Mudavadi, Tessie Musalia Mudavadi, said the incubators were meant to bridge a critical gap between the ability of health workers to save newborns and the equipment available to them.

“Behind every preterm baby fighting for life is a mother and a family waiting, praying and hoping that their child will survive,” Ms Mudavadi said.

She said a preterm baby could be born in a hospital where health workers have the knowledge, skills and commitment to save a life but lack the essential equipment required to provide care.

“It is this gap between the capacity to provide care and the resources available that preventable newborn deaths continue to occur,” she said.

The ninth phase of the programme saw neonatal equipment donated to Kisumu, Migori, Homa Bay, Siaya, Kisii and Nyamira, with officials saying the support would strengthen care for premature and critically ill babies.

Ms Mudavadi said the intervention comes as Kenya implements the Every Woman Every Newborn Everywhere (EWENE) Acceleration Plan 2026–2028, launched by President William Ruto in May to accelerate efforts to reduce preventable maternal and newborn deaths.

The plan targets 90 per cent attendance of at least four antenatal care visits, 90 per cent skilled deliveries, 80 per cent postnatal care within two days of delivery and 80 per cent access to emergency obstetric and newborn care within two hours.

She said the national plan would only have meaning if its commitments were translated into functioning services at county and facility level.

“We are turning national commitments into functional incubators, stronger newborn care services, and a better chance of survival for babies born too soon, our preterm babies,” she said.

Ms Mudavadi urged beneficiary counties to ensure the incubators are properly installed and maintained, saying equipment must remain functional and available when newborns need it.

“Government cannot do this alone. Neither can civil society, development partners, or communities working separately,” she said.

Director of Medical Services Dr Don Sunday Ogolla said Kenya had made greater progress in reducing deaths among children under five than among newborns.

He said neonatal mortality had fallen only slightly over the past decade, from 24 deaths per 1,000 live births to 21, compared with a larger reduction in under-five mortality.

The latest Kenya Demographic and Health Survey puts Kenya’s neonatal mortality rate at 21 deaths per 1,000 live births and under-five mortality at 41 per 1,000.

Dr Ogolla said prematurity was among the major challenges contributing to neonatal deaths, leaving babies vulnerable to infections, breathing difficulties and other complications.

He said premature babies also struggle to regulate their body temperature, making incubators an important part of their treatment.

“We have to manage them holistically. We must have an incubator because the incubator will manage thermoregulation, which is the main problem that they have,” he said.

Some premature babies require specialised feeding and respiratory support, while those unable to breathe independently may need mechanical ventilation.

Dr Ogolla said JOOTRH had established a neonatal intensive care unit capable of providing mechanical ventilation and other specialised services to critically ill newborns.

He urged women to attend antenatal clinics and couples planning pregnancies to seek preconception care, where conditions such as anaemia, hypertension and diabetes can be identified and managed early.

The World Health Organisation says premature birth, birth complications, neonatal infections and congenital anomalies remain among the leading causes of newborn deaths globally. In 2022, 2.3 million newborns died during their first 28 days of life, with nearly half of all under-five deaths occurring during this period.

Kisumu County First Lady Dorothy Nyong’o said the county wanted to bring neonatal deaths down further, saying the current national rate of 21 deaths per 1,000 live births was still too high.

“We are committed to working with you and any other partners who are willing to help us to bring those numbers down from 21 per 1,000 to 11, but I’m not happy with the 11. I would actually like to eradicate, if possible, to bring it to zero,” she said.“We don’t want to lose any babies, not even a single one.”

Ms Nyong’o said the attention given to mothers during antenatal and postnatal care should also provide an opportunity to address other health concerns.

She called for women to be screened for breast and cervical cancer while men accompanying their wives for care should be encouraged to undergo prostate cancer screening.

“Once she’s in our hands, I’d like to see a comprehensive approach so that we’re checking for the breast. Just because she’s pregnant or she’s had a baby does not mean that she cannot have breast cancer,” she said.

Migori County First Lady Agnes Ayacko said the equipment would strengthen care at Migori County Referral Hospital, which receives mothers and newborns referred from across the county and neighbouring areas.

She said the facility serves patients from parts of Narok, Homa Bay and Kisii and communities near the Tanzania border, making improved newborn care important beyond Migori town.

“The arrival of a baby should be a moment of joy. Yet for families whose babies are born too early or become ill soon after birth, it can also be a time of great fear and anxiety,” Ms Ayacko said.

She said the county reviews maternal and perinatal deaths to identify gaps in care and improve services.

“Equipment has its greatest value when it is ready for use and placed in capable hands,” she said, adding that the county would work with health facility teams to ensure the equipment is used, maintained and supported through training and mentorship.

Homa Bay County CECM for Public Health and Medical Services Grace Osewe said strengthening newborn care was part of a wider effort to follow mothers and children from pregnancy through the first 1,000 days of life.

She said community health promoters were helping identify pregnant women and link them to health facilities so that risks could be identified and managed early.

Osewe said the new equipment would allow more babies with low birth weight and other complications to receive care closer to their homes, reducing unnecessary referrals.

“When we lose a child or when we lose a mother, we lose a lot as a country,” she said.

Njoki Mambo, the programme's brand ambassador, said the equipment would give health workers additional support at a time when every moment can determine whether a premature baby survives.

“Behind every incubator is a mother willing to hold her child, a family hoping for good news and a healthcare worker doing everything possible to help a newborn survive,” she said.

For the mothers who attended the handover, the equipment represents more than hospital machines. It is a response to the uncertainty faced by families whose babies arrive before they are ready to survive outside the womb.

With neonatal deaths accounting for a large share of child deaths and prematurity remaining a major cause, WHO says improving care around childbirth and during the first week of life, including care for small and sick newborns, offers some of the greatest opportunities to improve survival.

The challenge for the six beneficiary counties will now be to ensure the incubators are installed, maintained and operated by trained personnel so that the support reaches the newborns for whom it is intended.