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November 16, 2018

Changing Kenya’s narrative as one of the most dangerous countries for women to give birth

Sid Chatterjee (c) presenting the First Lady Margaret Kenyatta with the signed agreement.
Sid Chatterjee (c) presenting the First Lady Margaret Kenyatta with the signed agreement.

It has only been a few months since we buried Elaine*. Her funeral was a sad affair. The reality even more depressing. Earlier in the year, Elaine was full of joy as she prepared to welcome her bundle of joy at a local private hospital. It was her second baby and the nerves usually accompanying first time mothers was  not present. 

A visit to her doctor for her final check up a few days to delivery was routine. In a shocking turn of events, Elaine died two days later.

 Her pressure during the checkup was extremely high and doctors had recommended an immediate caesarian section to save her life and that of her daughter, who now has to grow up without ever knowing a mother’s love. 

Her family is bitter often asking whether their precious daughter could have been saved. 

Ann’s* family is also in mourning She died suddenly after developing complications in her sixth month of pregnancy. Ann was feeling unwell and due to the fact that she was expectant, decided to go to the hospital for a check up. 

It was discovered that one of the twins she was carrying had died in the womb earlier which resulted in the other baby getting an infection. 

What followed next was a fight for her life and that of her remaining baby. A fight they lost three days later. 

Why did the doctors not pick this up earlier? 

Was it an oversight? 

What were all the check ups for if they did not detect an problem with the babies?

Should we have gone to a better facility? 

Maybe the doctor is to blame due to negligence?

All questions the family posed but did not qet the answers they sought. 

 

Reality

According to the World Health Organisation, maternal health refers to the “health of women during pregnancy, childbirth and the postpartum period.”

And for my expectant mothers, they often look towards having a  fulfilling experience. 

However, for too many women it is associated with suffering, ill-health and even death. The major direct causes of maternal morbidity and mortality include haemorrhage, infection, high blood pressure, unsafe abortion, and obstructed labour.

The United Nations Population Fund (UNFPA), has been in Kenya since 1974, and in the last four years, has been at the front lines of the war against maternal mortality and violence against women and girls.

At its helm is Siddharth Chatterjee, the organisation’s repesentative in Kenya. His passion, commitment and energy are changing things for the better. 

A former Major in the Indian Army Special Forces where he was decorated for gallantry in counter insurgency operations, Sid’s better-known profile has been his dedicated battle to unshackle women and girls from cultures that keep them away from school and out of the workplace.

 “I am passionate about eliminating narratives that hold women and girls as lesser beings.  

This largely emasculated half of humanity must be seen as the solution, to the world’s problems,” says Sid.

 

The defining moment

It is a passion that did not just begin with joining UNFPA. While serving in the army as a young officer, he was horrified to find out that a soldier from his unit had raped a young girl. 

“I remember the sheer fear and trauma that girl went through, and the helplessness of her family.” 

It was a life changing moment for Sid.  He says, while “the punishment that followed was swift and uncompromising, it was at that moment that I swore to fight all forms of misogyny, discrimination and violence”.

He is determined that the place to start is placing the terrible tragedy of high maternal deaths, discrimination and violence at the center of the country’s political, social, cultural and economic dialogue.

“We must get people talking about it and everyone doing what they can to change the view of Kenya as one of the most dangerous places in the world for women to give birth”, he says. 

Kenya ranks 10th among the 15 countries with the highest number of maternal deaths in the world. This means that between 5000 and 7000 women die every year due to complications during pregnancy or related to childbirth.

The government’s free maternity scheme and the First Lady Margaret Kenyatta’s Beyond Zero campaign have given the battle great impetus, earning her recognition as the 2014 UN Kenya Person of the Year, the first time the award has gone to a First Lady.

 

A Revised Game Plan

With 98 percent of these maternal deaths coming from only 15 counties in Kenya, one of the most visible results of partnerships was the H4+ initiative that UNFPA is spearheading. 

This has brought on board a number of private players to collaborate with the public sector in support of the reproductive, maternal, newborn, child and adolescent health (RMNCAH) project being implemented in six counties in Kenya with the highest maternal and child deaths. The counties are namely Mandera, Wajir, Marsabit, Isiolo, Lamu and Migori.

UNFPA is coordinating a partnership between the county governments, development agencies and the private sectors that seeks to develop locally appropriate technologies to improve maternal and child health and end harmful traditional practices like female genital mutilation and child marriage.

It has also spearheaded the Private Sector Health Partnership Kenya to complement ongoing work within the framework of the RMNCAH 6 County Initiative. From high-level engagement with county governors and members of parliament to community elders, UNFPA is pushing hard for a reduction in preventable maternal and child deaths.  

 

Milestones Achieved

There has been an incredible momentum to address disparities so as to significantly advance maternal and newborn health at all levels. Major strides have been made in areas of family planning and RMNCAH services.

For instance, access, utilisation and quality of integrated RMNCAH and HIV services has significantly improved, while the demand for RMNCAH and HIV services by marginalised communities has increased. 

Also institutional capacity building at county and national level has been achieved through procurement and distribution of assorted RMNCAH equipment, trainings of staff and renovation of maternity and theatre units. UNFPA has also strengthened monitoring and evaluation systems of health systems at county and national level.

“We are firm in the belief that when women and girls are empowered, first by being supported to stay in school and thereafter to join the workforce, the country will have started laying the concrete foundation for reaping the demographic dividend,” Sid affirms. 

about,” says Sid.

 

The need for collaboration

UNFPA worked with the Ministry of Health and the First Lady Margaret Kenyatta to get governors from the 15 counties to commit to direct more resources to maternal and child health issues; parliamentarians from those counties thereafter endorsed a signed communiqué from the governors.

With the realisation that health problems cannot be solved through medical solutions only, in March 2015, UNFPA reached out to religious leaders and through the Inter Religious Council of Kenya, also lobbied for a signed Call to Action from all major faith groups, to equally advocate for an end to maternal deaths.

The engagement with these leaders is an acknowledgement that drivers of women’s exclusion – including practices such as child marriage and FGM, are wrongly given a religious imprimatur, thus making their elimination a greatly arduous challenge.

“We took deliberate care to ensure that our activities were in tandem with the country’s vision, especially as enunciated in Kenya’s Vision 2030. It is out of this close partnership that President Uhuru personally opened a meeting in March 2015 where for the first time, religious leaders from different faiths committed to supporting the campaign to eliminate gender based violence including female genital mutilation,” says Sid.

“We aim to keep to the principle of “leave no one behind”, to continue to confront the challenges of reaching the last frontiers, and to do our part to bring down the drivers of exclusion that shackle mothers, sisters and daughters around the country,” he adds. 

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