Hire enough nursing specialists to curb maternal and child deaths

80 per cent of maternal deaths in Kenya are attributed to poor quality of care. [iStockphoto] By the time you finish reading this article, two women will have died during pregnancy or childbirth. Intensive deliberations at the recent Pan African Nurse Anesthetists Conference (PANAC) in Nairobi prescribed the hiring of anaesthetic nurses to curb mother and infant deaths across the continent. Reviewing studies conducted in dispensaries, health centres, and other major hospitals, the PANAC conference observed that well-staffed hospitals reported better Maternal and Child Health (MCH) outcomes as opposed to inadequately staffed health facilities. Anaesthetic nurses provide pain medication (anaesthesia) care for patients before, during, and after surgery. They administer medications to keep patients asleep or pain-free during surgery and constantly monitor every biological function of the patient's body, thereby helping patients, mothers' and infants' health to improve at a faster rate. As Mahmoud Fathalla said, "Women are not dying because of untreatable diseases, they are dying because societies have yet to make the decision that their lives are worth saving. We have not yet valued women's lives and health highly enough." While the one-time International Federation of Obstetricians and Gynaecologist President made this statement 18 years ago, today it is true that maternal mortality remains a major challenge globally with Africa accounting for 70 per cent of global maternal deaths. To significantly reduce maternal mortality rates worldwide, Prof Fathalla recommended that urgent measures be taken to ensure women have access to safe, timely, and affordable surgical care that is supported by investments in healthcare infrastructure, training, and community education. The conference lamented that with just six short years before 2030, progress towards Sustainable Development Goal 3.1 had stagnated with the situation aggravated by the Covid-19 pandemic. In addition to challenges in accessing healthcare, the unavailability of anaesthetic nurses at health facilities make it difficult for health professionals to detect abnormal vital signs in acutely unwell patients who require proper care leading to maternal and neonatal deaths. As Kenya races to realise universal healthcare coverage, we should prioritise the provision of better healthcare services for new mothers and their infants regardless of their location in the country. Kenya, like many African nations, faces a profound challenge in ensuring equitable access to maternal and child healthcare. Even though there have been significant advancements in construction of healthcare facilities, there is still a severe shortage of qualified medical personnel, especially in rural and underserved communities. This disparity not only affects the quality of care but also has dire consequences for the health outcomes of mothers and children. Studies presented at the conference show part of the challenge for effective maternal and child health in Kenya is a significant shortage in the anaesthesia workforce. A 2017 survey by the World Federation of Societies of Anesthesiologists found that Kenya had just 0.44 physician anesthesiologists for every 100,000 people. When non-physician anaesthesia providers are included, this number increases to only 1.7 per 100,000. This is still well below the recommended 4 per 100,000. For many expectant mothers in Kenya, the journey to a healthcare facility is just the beginning of their horrendous ordeal. The absence of trained professionals, such as nurse anaesthetists, can determine whether they (mother and child) will live or die. Nurse anaesthetists play a crucial role in providing safe and effective pain management pre-birth, during and after childbirth, thereby ensuring that both mother and child receive the best possible care. -Ms Mungai is the Patron, Association of Registered Nurse Anaesthetists-Kenya

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