Mothers next month will have access to a new drug that prevents excessive bleeding after childbirth.
The government has procured 360,000 doses of heat stable carbetocin, a new formulation vital in reducing maternal mortality.
The consignment of heat stable carbetocin, which does not require refrigeration, is expected to arrive in March.
The medicine remains effective for at least three years stored at 30 degrees Celsius and 75 per cent relative humidity.
Heat stable carbetocin will be used along with oxytocin, which is the first-choice drug for preventing excessive bleeding after childbirth.
Dr Edward Serem, however, said, oxytocin must be stored and transported at between two and eight degrees Celsius.
Serem is the Head of the Maternal and Reproductive Health Division at the Ministry of Health.
“Not many regions in Kenya can sustain these levels of refrigeration, and that means when the women get the medicine for preventing the bleeding, it has completely lost its potency because of exposure to higher temperatures,” Serem said.
The ministry is including the medicine as an option following Kenya’s participation in the world’s largest clinical trial called Carbetocin Hemorrhage Prevention, commonly known as the CHAMPION Trial.
The study tested the effectiveness of the medicine alongside oxytocin on 30,000 women who gave birth vaginally in Kenya, Argentina, Egypt, India, Nigeria, Singapore, South Africa, Thailand, Uganda and the United Kingdom.
The results published in the “New England Journal of Medicine” showed it to be safe and as just as effective as oxytocin, which Kenya has used for years.
The Ministry of Health has also tested the medicine in 11 counties.
Heat stable carbetocin was available in the country but only in the private sector, where the prices were prohibitive for most public health facilities.
“In a few weeks, counties can now order the medicine from the Kenya Medical Supplies Authority at a fair price of Sh92 shillings per dose, a drop in price from Sh1,444 per dose,” acting director of commercial services at Kemsa Jackline Mainye said.
Postpartum hemorrhage in which women bleed uncontrollably after childbirth, is the deadliest of all complications during childbirth.
A 2017 investigation into all the deaths of mothers by the ministry showed that PPH is responsible for two in every five women’s deaths in Kenya during and after childbirth in Kenya.
Failure of the uterus to contract adequately after childbirth is the most common cause of postpartum hemorrhage.
“Administration of medicines within one minute of childbirth is one of the most critical steps in preventing excessive bleeding after childbirth. Use of quality-assured medicines is the game changer,” Michael Mwiti said.
Mwiti is a midwife and maternal health specialist from the affiliated Johns Hopkins Programme for education in Gynecology and Obstetrics (Jhpiego).
Dr Daisy Ruto, an obstetrician-gynecologist from Jhpiego said severe bleeding is one of the killers in women.
“Bleeding excessively after birth can kill a healthy woman within hours if she is unattended and provided quality access to uterotonics such as oxytocin, heat stable carbetocin and others, immediately after childbirth. They effectively reduce the risk of bleeding,” Ruto said.
When the woman does not die, complications may force doctors to perform emergency hysterectomies (removal of the uterus), especially when hospitals have too little stored blood store provide transfusions.
Maternal mortality remains high in Kenya, placing it in the “very high” category of the World Health Organization.
While lack of medication is one cause of excessive bleeding that remains stubbornly high, a ministry report in 2017 indicated that 91 per cent of women who died received suboptimal care. Different management would have resulted in a positive outcome.
The report further highlighted that suboptimal care was due to inconsistent treatment practices that do not adhere to standard guidelines, the lack of equipment, a poor referral system and understaffed hospitals.
In response to the arrival of the medicine, the government solicited support from multiple development partners and donors to train healthcare workers on the appropriate use of the treatment.
The project Smile for Mothers trained more than 1,400 healthcare workers in 40 public health facilities in 10 counties with stubbornly high levels of post-partum hemorrhage.
The 10 include Kilifi, Garissa, Kitui, Tharaka Nithi, Kiambu, Nairobi, Nakuru, Kakamega, Kisumu and Migori.
The integration of medicine in a health system was tested in Makueni county.
WHO reports that a woman dies during pregnancy or childbirth every two minutes, a number that resulted in 287,000 maternal deaths worldwide in 2020; 70,000 of these were from post-partum hemorrhage.
The death of the mother increases the risk that their babies also die within one month.
