Training traditional midwives helps county 'get' more babies

Rehema Chengo is due to deliver her eighth baby next month. But unlike her first seven pregnancies, this time round she has been attending clinic.

Previously, she gave birth at home with the help of a traditional birth attendant (TBA).

“I delivered my other babies at home because I didn’t know the importance of going to the clinic until this year when my traditional birth attendant advised me to start attending clinic at the Kilifi referral hospital,” She says.

The decision was easy for Rehema after she heard of the dangers that come with home delivery.

“It is a game of chance,” she says.

According to the World Health Organisation (WHO), a TBA is an individual who assists a woman during childbirth and who initially acquired her skills by delivering babies herself or by working with another TBA.

Rehema says she feels different with this particular pregnancy because she did not experience any pregnancy complications like before.

‘’In my last trimester I usually experience lower abdominal pains and walking becomes impossible. But this time around the journey is quite different because I have been following all my doctor’s instructions and all is well,” she says.

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Dr. Wilfred Tunje Mwabonje has been her doctor at the Kilifi Referral Hospital and he says TBAs act as a bridge between health centres and the community as they sensitize women on nutrition and hygiene. TBAs also follow up with mothers to ensure they attend antenatal classes and then deliver at the health centres.

In 2023, the Kenya Red Cross in partnership with the Kilifi county government trained 25 TBAs and 25 community health volunteers to curb maternal deaths. The TBAs are given incentives for every referral. Women who choose to give birth in hospitals are also rewarded.

At the heart of this project was taking vital health information to pregnant women and encouraging them to give birth at health facilities. Experts knew traditional birth attendants were trusted by mothers so they were invited to become campaigners for giving birth at health centres.

The TBAs were trained on treating basic problems, recognising warning signs of a complicated pregnancy, and referring risky cases to a skilled medical practitioner. The training included knowledge exchange with health practitioners and gynaecologists.

Statistics from the Kilifi Referral Hospital show that there was an improvement in the uptake of skilled health delivery in 2023 compared to last year.

Kilifi North Reproductive Health Coordinator Philomena Munga says integrating the TBAs has made a major difference. So far the TBAs have referred 30 pregnant women to clinics in the past two months.

“The advantages of delivering in the clinic are significant, particularly in preventing the transmission of HIV during childbirth. Delivering with the assistance of a skilled nurse decreases the risks of maternal mortality and morbidity, and infants with health issues can receive immediate medical attention’’ she says.

“Hemorrhages have been the major cause of maternal deaths in Kilifi County. The project’s target was to reduce neonatal death by 15 per cent but we reduced it by 28 per cent and maternal mortality was reduced by 22 per cent since the beginning of 2023,” Philomena said.