KUDOS MR PRESIDENT! Let Women Give Birth and Live to See their Children Play

Causes of neonate and maternal deaths are well known and can be prevented. According to the MDG Report on Africa (2013),  “majority of neonatal deaths result from complications related to preterm birth or complications during birth. Delivering at home without a skilled health-care provider leaves women and babies at greater risk of such complications, and thus accessing health care during pregnancy and delivery is essential for improving both maternal and child health. Simple interventions such as folic acid supplementation, pre-eclampsia and eclampsia prevention, malaria treatment, clean delivery practices and breastfeeding can drastically reduce neonatal morbidity and mortality”.

The 2008-09 Kenya Demographic and Health Survey (2008-09 KDHS) reported that only 47 percent of all pregnant women make the four WHO-recommended focused AnteNatal Care (ANC) visits. Out of these, more urban women (56%) compared with their rural (44%) counterparts seek ANC services. Despite its importance, only 15 percent of pregnant women seek antenatal care in the first trimester (KNBS and ICF Macro 2010).  

The KDHS 2008-09 also observed that despite high ANC service seeking, only 43 percent of deliveries happen in a health facility while majority (56%) of women, especially those in rural areas deliver at home and without skilled care. This is a worrying trend considering that home deliveries are responsible for high neonate and maternal deaths in Kenya. While maternal death refers to death of a woman due to pregnancy and childbirth complications, neonatal death refers to death of a live birth occurring within the first month (28 days) of life.

Globally 40 percent of deaths to children under-five occur in the very first month of life with three-quarters of which occur in the first week of life (Springer, 2013). 99 percent of these deaths occur in developing countries.  According to the latest MDG report, 33.6 percent of under-five deaths in Africa usually occur in the first 28 days of life (neonatal period).  While neonatal deaths account for such a high number of all childhood deaths, globally, historically, neonatal mortality receives limited attention (Oestergaard, et al, 2011).

In Kenya, most neonates die within less than 24 hours upon birth.  KNBS (2010) observes that “high maternal and neonatal deaths occur during the first 48 hours after delivery” a situation also observed by UNDP (2010). A neonatal and perinatal mortality study done in Kilifi district in the Coast Province of Kenya using 2004-05 Demographic Surveillance Systems (DSS) data found that neonatal death was the highest contributor to infant deaths (65 percent) (Bauni, et al, 2005). A situation acknowledged by the United Nations Millennium Development Goals (MDGs) report of 2010 for Kenya.

President Uhuru Kenyatta’s directive to all public health facilities to provide free maternal healthcare is indeed a stitch in time. While it provides a glimpse of hope to poor mothers, it is also a step towards direct achievement of at least three Millennium Development Goals (MDGs). It strengthens the country’s resolve to reduce infant and indeed neonatal mortality (MDG 4); drastically reduce maternal mortality (MDG 5) and empower women (MDG 3). At the same time, this move will support improvement of the socio-economic status of families (MDG 1) and a reduction in HIV infection (MDG 6).

International goals aside, free maternal healthcare is in line with objectives of our health strategic focus and attainment of V2030. Besides, this initiative puts our health system in better standing in terms of collecting vital statistics for better planning and socio-economic development. Incrementally, Kenya will be working in line with the Africa Programme on Accelerated Improvement of Civil Registration and Vital Statistics.

Think about it!