Every year, 15 million babies around the world are born prematurely—before 37 weeks of pregnancy. In Kenya, one out of every eight babies born is preterm. Tomorrow, Kenya joins the global community to mark World Prematurity Day. This day provides an opportunity to focus on the loss of life, disability, and pain and suffering caused by preterm birth.
Kenya has joined 192 other countries to ratify the Global Goals for sustainable development. Goal number 3 seeks to end preventable newborn and child deaths by 2030. Every pregnant woman hopes for a healthy baby born maturely. However, the risk of premature birth is a major concern to all women, though most pregnant women are completely unprepared to take care of premature babies.
Kenya is ranked 15th globally in number of premature births out of 188 countries. Causes of preterm births include short intervals between pregnancies, malaria, malnutrition, low weight and age of the mother. Most of these can be addressed when identified early, especially when mothers attend antenatal clinics.
Preterm babies need extra care to increase their chance of survival. The stress, pain and emotional anxiety that goes with being the parent of a premature baby is intense. Premature birth contributes to delayed lactogenesis (onset of milk production) among some mothers. These mothers require additional support to initiate and support breastfeeding, including psychosocial support and counselling. The mothers often feel lonely and isolated, and require assurance and support from other mothers who have raised premature babies.
Premature births also affect the health system and the economy as families spend a lot of money seeking quality care for their newborn. Families incur huge bills arising from prolonged stay in hospital before premature babies and their mothers are discharged.
Some innovations seek to address these challenges, especially now as the country plans to adopt universal health coverage. Some of these simple and cheap interventions are improved access to breast milk and Kangaroo Mother Care (KMC), which is prolonged skin-to-skin contact between low birth-weight babies and their mothers. Our government needs to invest in strengthening KMC and breastfeeding promotion to reduce the cost of hospital stays and prematurity related deaths.
Neonatologists report that premature babies face feeding challenges which if not addressed can contribute to infections or death. Breastfeeding is the single most powerful intervention capable of reducing deaths associated with prematurity. However, some premature babies do not have access to their own mother’s milk. Use of alternatives such as formula increases the risk of infections which if not properly managed can result in death.
In the absence of mother’s own milk, the World Health Organisation (WHO) recommends safe donor human milk as the next best alternative. Provision of safe donor human milk should not be a standalone intervention but integrated into breastfeeding promotion and Kangaroo Mother Care. Unfortunately, safe donor human milk is currently not available in Kenya.
The good news is that Kenya is in the process of establishing the first human milk bank. This is an integrated model which aims at ensuring equitable access to human milk. A diet of exclusive human milk goes a long way in saving the lives of premature babies, while also reducing the cost of hospital stays and purchase of other milk alternatives. Kenya’s first human milk bank is being established at Pumwani Maternity Hospital and is expected to: Provide safe, quality donated human milk to vulnerable infants in the New Born Unit (NBU), improve breastfeeding rates, increase access to human milk in the NBU and improve neonatal health outcomes in the NBU.
During this World Prematurity Day, I call upon all stakeholders to support saving the lives and improving the well-being of mothers and their premature babies. It is important for communities to end the stigma on premature babies and believe in their future- these babies too have the ability to strive for excellence grasping on the numerous opportunities the world holds for them.
My strong message would be an increased awareness aimed at changing negative community attitudes towards premature birth, newborn health and survival. Additionally, it is important to raise awareness on the available low cost interventions that can improve the survival rates of premature babies. These babies are our children and they can grow up strong and healthy with the right healthcare and support.
Maternal and Newborn Health, County Innovation Challenge Fund