Public hospital delivery no better than home births?

New mothers Ruth Amino and Milka Nyaboke at the Coast Provincial General Hospital on March 7, 2015 /ELKANA JACOB
New mothers Ruth Amino and Milka Nyaboke at the Coast Provincial General Hospital on March 7, 2015 /ELKANA JACOB

A new Harvard University study suggests giving birth in some of Kenya’s health facilities is no better than delivering at home.

The government has encouraged women in rural areas to deliver in dispensaries and health centres. The Harvard University Chan School of Public Healthy report says this may not necessarily save lives because many health centres are understaffed and medics cannot deal with complications.

“The current strategy of birth at any clinic is likely wrong. Poor quality is undermining the goal of reducing maternal and newborn mortality around the world,” associate professor Margaret Kruk said.

The research team said it only analysed data from health system surveys funded by USAid in Kenya, Namibia, Rwanda, Tanzania, and Uganda because these countries have high maternal mortality rates.

The researchers said 40 per cent of births happen in poor-quality facilities which lack infrastructure, referral systems, and routine and emergency care.

The study called ‘Quality of basic maternal care functions in health facilities of five African countries’, was published last Friday in the Lancet Global Health online journal.

It said many women who give birth in rural health centres die of complications. Data shows the free maternity programme has reduced maternal mortality.

Ministry of Health head of planning Peter Kimuu yesterday said within the first year of its launch, deliveries in public health facilities increased from 418,325 to 627,487.

This translates to 61 per cent of all deliveries being in public institutions. The ministry says delivery in health facilities saves the lives of more than 2,000 mothers every year in addition to saving the lives of 30,000 children under the age of five annually.

Harvard researchers measured the quality of basic maternal care at 1,715 health care facilities using 12 indicators, including the availability of skilled providers, a functional ambulance, electricity, clean water, and antibiotics.

They also looked at whether quality was linked to volume of births per year or to a facility’s capacity to perform C-sections.