Good systems key in reducing maternal, newborn deaths
In Kenya, pregnant mothers and, or newborn babies are 25 times more likely to die at birth than those in developed countries. Unfortunately, reduction in maternal and neonatal mortality is slower than the global average and below other African countries such as Tanzania, Rwanda and Malawi. They implement evidence based, high impact interventions and utilize their systems, from community services to referral facilities.
A strategy for strengthening Maternal and the Newborn Health (MNH) is under way in Kenya and has been reinforced by the “Beyond Zero Campaign” of the office of the First Lady which aims at preventing maternal deaths, zero preventable under five child deaths and zero mother to child HIV transmission.
County advocacy for MNH services has been strengthened by communication and social mobilisation committees. In addition, there is increasing access to MNH services with a growing number of facilities with neonatal intensive care units. Training of skilled birth attendants and improving supplies and equipment are adding to improved services.
In future, improved information systems will result in the provision of better facilities with qualified staff. The national guideline for maternal and perinatal deaths surveillance and response intended to implement a complete audit of the death of a newborn, or mother to enable it generate action points for future preventive measures.
Facility and County-based implementation of the plan is key to the rapid improvement in the quality of services offered to newborns and their mothers. Effective community based actions will translate into the success of the programme.
The gap between the national policy and the available services around the country requires auditing and the development of facilities, training and deployment of qualified personnel. Establishment of high quality newborn services is expensive and unattainable at County level in many cases, which requires an effective referral system with well-coordinated highly specialized centres around the country.
Centres of excellence for training are required together with the provision of specialized care. In line with this thinking, the Aga Khan University Hospital is developing a Neonatology Training Programme which will be the first in Africa outside South Africa to improve access to specialised training in maternal and newborn health within the continent.
Dr Peter O. Gisore, Consultant Neonatologist, Department of Paediatrics at Aga Khan University Hospital, Nairobi.
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