Traditional birth attendants in Isiolo and Marsabit counties are demanding access to skilled delivery services and equipment to improve services.
The TBA's demands are included in a women and children's health report by the Kenyan government, UN agencies and the World Bank. It says that as they learn, TBAs want to do better and want more training and assistance.
The report — covering progress and problems — surveyed July 2015 to December 2020. It also says socio-cultural barriers in the two counties have led to the low utilisation of key interventions such as maternity shelters.
The UN partners are UNaids, UNFPA, Unicef, WHO and UN Women. Insecurity is a challenge to the delivery of quality maternal and other health services in Mandera, Wajir and Lamu, particularly due to the high turnover of trained health care workers. They flee terror attacks.
The Sh2.2 billion programme on Reproductive, Maternal, Newborn, Child and Adolescent Health was implemented regions with the highest maternal and infant mortality.
They include Isiolo, Mandera, Marsabit, Wajir, Migori and Lamu counties.
The aim of the programme is that by 2020, the six counties will have better integrated, quality reproductive, maternal, newborn, child, adolescent health, HIV and anti-gender-based violence services. The aim is to reduce maternal and infant mortality.
“Whereas the six target counties bear the biggest burden, paid health services remain inaccessible to many, due to high poverty levels,” the report reads.
The WHO standard requires a health facility be no more than five kilometres away, but in the focus counties, the facilities are 50 to 200km apart.
Mandera’s maternal mortality rate is estimated at 3,975/100,000 compared with the national average of 488/100,000.
Wajir's total fertility rate was 7.9 compared the national average of 3.9 births per woman based on the Kenya Demographic and Health Survey.
Use of modern contraceptives is only three per cent for Northeastern counties compared to the national average of 58 per cent.
“The programme has shown a little investment done right and done smart can change health outcomes. It has motivated investments by the counties themselves in these critical areas,” UN Fund for Population Activities for Kenya, Dr Ademola Olajide, said.
The report shows a significant increase in use of life-saving health services, improved access and quality of integrated maternal health services. It also shows improved services for those living with HIV and survivors of GBV between 2015 and 2020.
The report says the number of women who used antenatal care increased by more than 32 per cent.
Access to skilled attendance at birth also increased by 30 per cent as a result of community-based advocacy, improved infrastructure and health equipment by the UN programme.
The report said the number of women who received HIV testing and counselling at antenatal clinics increased gradually from 2015 to 2020. Lamu recorded the greatest increase from 40 per cent to 99 per cent.
“This is a critical milestone in achieving Kenya’s target to eliminate mother-to-child transmission of HIV,” the report reads.
“We call on partners to support and leverage on the gains in the last five years to ensure targeted groups in the six counties continue to receive RMNCAH, HIV and GBV services," WHO representative to Kenya, Dr Rudi Eggers, said.
The report calls for continued resource mobilisation, building strong partnerships and leveraging existing programmes to build the capacity of healthcare workers.
(Edited by V. Graham)
