Top 10 killers of Kenyan women
It is worrying that many Kenyan women are losing their lives to preventable diseases. NJOKI CHEGE explores the top ten killers
Maternal deaths are the number one killer of Kenyan women. Maternal mortality is the death of a woman while pregnant, during or after delivery or within 42 days of termination of pregnancy. The cause of death should relate to the pregnancy.
Maternal mortality deaths have not improved in spite of efforts by the public and private sector. The current ratio stands at 488 deaths per 100,000 births, a sharp contrast from developed countries that register less than ten deaths per 100,000 births.
The top five killers linked to maternal deaths include haemorrhage, sepsis, hypertensive disorders of pregnancy, obstructed labour and complications of induced abortions.
Postpartum haemorrhage (PPH)/obstetric haemorrhage accounts for 25 per cent of the total maternal deaths in Kenya. PPH is vaginal bleeding in excess of 500ml within 24 hours after delivery. Severe PPH is blood loss exceeding 1,000ml. This condition is common among 56 per cent of women who do not deliver in hospitals.
Dr John On’gech, the head of Obstetrics and Gynaecology at Kenyatta National Hospital, attributes these deaths to lack of a birth plan and adequate preparedness.
"There is great need to deliver in hospital under skilled attendants. There is also need for a birth plan. Attend the clinic often during pregnancy and be prepared for emergencies," he says.
2.Hypertension pregnancy disorders (HPD)
Hypertensive disorders represent the most common medical complications of pregnancy. It is probably the reason why they are the second biggest killers after PPH at the Kenyatta National Hospital. The main cause of HPD is failure of expectant mothers to visit the clinic. It is estimated that 90 per cent of pregnant women go for a first antenatal clinic, but the number reduces to 70 per cent at the second visit and even lower in consequent visits.
It is advisable to take clinic attendance seriously to reduce chances of HPD and then ensure you deliver in a hospital.
This particularly affects young women who fall victim to unplanned pregnancies and end up procuring abortions from backstreet ‘doctors’.
Dr On’gech advises safe sex practice among young people. According to him, youth need to bring themselves to the realisation that there is always a price to pay for unprotected sex.
"We also need to empower our girls to make good choices when it comes to their sexuality. In the event of unplanned pregnancies, it is advisable to discuss this situation with professionals for safer options of addressing the situation," he says.
This is another major killer attributed to home deliveries. It accounts for 15 per cent of total maternal deaths in Kenya. Postpartum infections comprise a wide range of entities that can occur after vaginal and caesarean delivery or during breastfeeding. In addition to trauma sustained during the birth process or caesarean procedure, physiologic changes during pregnancy contribute to the development of postpartum infections.
This occurs when a baby is too big for the birth canal or the birth canal is too small for the baby. Normally, this is not an issue when you deliver under the care of a professional, but can become fatal when the delivery takes place at home. The results of obstructed labour include fistula — a ruptured uterus — and death.
Kenyan women are also dying from indirect maternal-related complications such as malaria, Aids, anaemia and tuberculosis.
In Kenya, two cancers are heavily implicated in claiming the lives of our women. These are cervical cancer and breast cancer.
It is a vaccine-preventable cancer yet it is one of the leading killers of Kenyan women. The main cause of this curable cancer is certain strains of the Human Papilloma Virus (HPV), which also causes genital warts. HPV is the most common sexually transmitted infection, more common than gonorrhoea or syphilis. It is highly contagious and spreads through skin-to-skin genital contact. Penetrative sex is not necessary for infection to occur.
More than ten million Kenyan women over the age of 15 are at risk of developing cervical cancer. Five women die of the disease every minute in Kenya yet less than one per cent of women go for regular pap smears that would detect most cervical cancers at an early, treatable and curable stage.
Dr Brigid Monda, a leading gynaecologist, says most women diagnosed with cervical cancer have either never had a pap test or have not had one in the last five years.
Dr Monda advises early detection through testing for the HPV virus or pap smear screening and vaccination against HPV infection.
It is recommended for girls from the age of nine to 16 before they become sexually active and also for all women up to the age of 55.
2. Breast cancer
It is the most common cancer and it has claimed thousands of Kenyan women.
The chance of getting breast cancer rises with age. About two of three women with breast cancer are of ages 55 or older in developed countries and age 45 in the African setting. The risk of breast cancer doubles with women whose close relatives have the disease.
Dr Catherine Watta Nyongesa, an oncologist, reckons that while there is no sure way of preventing breast cancer, you can lower the chances by controlling risk factors such as body weight, physical activity and diet.
While the prevalence of diabetes among women in Kenya is not known, the estimated prevalence of diabetes in Kenya is 3.3 per cent. Women who have a family history of diabetes are prone to diabetes in pregnancy. Diabetes is heavily linked to hypertension and obesity.
Dr Eva Njenga advises you to prevent diabetes and hypertension by maintaining an ideal weight through exercising and eating a balanced diet that is not high in carbohydrates or calories. You are advised to reduce your salt intake and get regular medical checkups to diagnose diabetes or hypertension in the early stages.
The Human Immunodeficiency Virus (HIV) disproportionally affects women because more women (8.8 per cent) than men (5.5 per cent) of age 15-49 are infected.
This disparity is even greater in young women aged 15-24 who are four times more likely to become infected with HIV than men of the same age.
Kenyan women experience high rates of sexual violence, which is thought to contribute to the higher prevalence of HIV. In a 2003 nationwide survey, almost half of the HIV-positive women experienced violence and a quarter of women aged between 12 and 24 had lost their virginity by force.
3. Road carnage/general accidents
Road carnage has become a national disaster, with the Traffic Police Department recording over 770 deaths. Over 400 of these were pedestrians, which means all road users are at a risk. To prevent this, drive safe, avoid reckless driving and observe traffic rules.
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