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Concern as congestion forces hospitals to discharge mothers hours after delivery

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By -STANDARD ON SATURDAY TEAM | August 3rd 2013

By STANDARD ON SATURDAY TEAM

New mothers are being discharged from some public hospitals a few hours after delivery to make way for others seeking free maternity services.

Others are being induced to labour to shorten their hospital stay, this newspaper has learned. There are concerns that pressure to free hospital beds could lead to health complications for mothers and newborns.

Other hospitals have discharged women who would previously have been detained over unpaid bills.

A doctor in Nyahururu says an increase in demand for maternity services has reduced the discharge time to 15 hours after delivery, potentially putting the lives of mothers and newborns at risk.

Previously women stayed in hospitals for at least one day after delivery and four days after caesarean section. Rising numbers of women seeking free maternity services is now raising concern in parts of the country as mothers throng crowded maternity wings.

While the Jubilee Government has increased medical staff in hospitals and provided equipment and other supplies, patients are flocking ‘preferred’ facilities causing overcrowding.

A crisis is looming over the high numbers that could lower the quality of service and discourage mothers from delivering in hospital. Senior officers in Siaya, for instance, say the patients need to be shared out between all facilities. In other counties, doctors have called on the Government to increase supplies and employ more staff to cope with the rising numbers.

Share a bed

At the Nyahururu District hospital, the situation is dire as two pregnant women share a bed. According to sources at the hospital, the number of pregnant women has doubled since last month. The maternity ward, which has 60 beds, now caters for more than 100 women.

A doctor who sought anonymity since he is not authorised to speak to the Press said this has been the situation at the hospital for the last one month.  “The number of women visiting the maternity wing is increasing day by day. We need more facilities,” he said. He said they are now being forced to discharge women 15 hours after delivery contrary to normal practice. “We discharge them immediately we realise they are in a stable condition,” he said.

The doctor said the hospital was understaffed and they are forced to work 24-hour shifts. Efforts to get a comment form the hospital superintendent Dr Lawrence Kamande were futile as his phone went unanswered. The World Health Organisation says discharging women in the first few days poses no threat to their healthy as long as the babies are normal-weight and are born without complications.

“Opponents of early discharge think it might lead to increased risks for the newborn (increased cases of jaundice, feeding problems and infections), but the evidence to support these claims is not compelling,” the WHO says. “Some health-care providers believe (it) could actually be beneficial, allowing bonding between the baby and the parents in the home environment.”

The Embu Provincial General Hospital has also seen the number of maternity patients double since June 1. Medical Superintendent Gerald Ndiritu said the hospital was receiving between 30 to 40 expectant mothers daily up from 20. He added that this has led to an increase in hiring costs of casual workers, drugs and non-pharmaceutical supplies over the last three months.

“We are relying on money from the cost sharing funds kitty because the Government has not released money for free maternity,” Ndiritu said. “On average, the Government should reimburse us at a rate of Sh5,000 per patient. We get 550 deliveries each month so we expect a refund of Sh7.5 million.”

He said deliveries averaged 16 per day and the workload for the doctors and nurses had increased, while the staff remained the same.

“The maternity, labour, antenatal and postnatal sections have a combined bed capacity of 148. Bed occupancy is now at 80 per cent and occupancy duration has reduced. We are not stretched out because no patients are retained in hospitals as they wait to pay their maternity fee,” Ndiritu said.

He said the hospital used to charge between Sh2,000 to Sh3,000 for normal deliveries and Sh5,000 for caesareans but has since scrapped those charges. They, however, still charge Sh200 for files and Sh100 as registration fee. Mr Patrick Mugendi, 24, who had brought his wife Ms Jackline Murugi to deliver at the hospital, confirmed that he had been charged only Sh300.

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