The
Jubilee administration made maternal healthcare free in 2013 to encourage women to deliver babies in hospitals and thus reduce maternal deaths.
The country's maternal mortality rate stands at 488 per 100,000 live births, according to the Kenya Demographic Health Survey. The survey lists hypertension and haemorrhage as the
most common causes of maternal death.
Despite the free maternal health care offer, little or no change has taken place in Homa Bay county, whose maternal death rate is 583 per 100,000 live births.
This is largely because of the active role Traditional Birth Attendants, locally known as min Jossy, play in helping women deliver at their homes.
To prove it, Star visited the home of famous TBA Petty Akoth, 66.
Akoth says she has helped thousands of women deliver babies at her home in Sofia estate, Homa Bay town.
Her improvised maternity ward
is ever flocked with pregnant women.
“Hundreds of women, including trained nurses and clinicians, come for my delivery assistance in this room,” Akoth says as she points at photographs of children she has helped deliver.
The TBA began assisting women in her mid-20s and has since gained experience.
She says she has taken several trainings on midwifery to ensure safe deliveries.
“I have training certificates, including the award from African Medical Research and Education Foundation in 1992,” she says.
One of the Akoth’s clients, Janet Abuya, 26, explains why they prefer TBA delivery to health facilities.
“Most health workers in public hospitals harass and carelessly handle us. They often leave expectant women in the hands of trainees,” Abuya says.
Abuya says trainees in public hospitals rarely understand the birth complications dogging safe delivery as midwives do.
“I moved to this place and got helped when I developed complications in my previous delivery. There’s no need of delivering elsewhere when min Jossy can assist without a hitch,” Abuya says.
Moreover, Akoth liaises with hospitals to help safeguard women’s health and safe deliveries.
“I normally want clients to make prenatal visits here before delivery so I’m able to know if they can develop any complication during birth,” she says.
NO MEDICAL EXPERTISE?
Homa Bay Clinical Services deputy director
Kevin Osuri says TBAs
should never be encouraged in the society to attend to expectant women. He says they lack the medical
expertise needed for safe deliveries.
“There is a high risk of HIV transmission from mother to child in TBA deliveries,” Osuri says.
The health officer says maternal mortality rate is high in Homa Bay due to increase in number of women opting to deliver at the homes of TBAs.
He says TBAs lack knowledge to advise women on nutrition, promoting stunted growth among children in the county.
“They are untrained, hence women who develop complications during deliveries may bleed profusely to death,” Osuri adds.
Despite the campaign against TBAs, Akoth says she receives clients from as far as Tanzania.
Homa Bay Health executive Richard Muga acknowledges the role played by traditional midwives but encourages expectant women to deliver in health facilities.
Muga says his department has embarked on empowering community health workers to take up the role of TBAs because a home delivery is a risk.
“We do not support expectant women to deliver at home or anywhere except at health facilities, where there are experts who can assist in case of complications,” Muga says.
“To reduce the county's worsening statistics on HIV prevalence, we have trained community health workers to encourage and assist women to deliver in health facilities.”
NEED FOR SKILLS
When Governor Cyprian Awiti declared HIV-Aids a county disaster, he
said his government would start training TBAs together with community health workers.
“We want TBAs to transfer expectant women who visit them to hospital for safe delivery,” Awiti said.
The governor said a skilled and well-trained midwife is capable of providing health intervention among women during pregnancies, childbirth and immediate post-natal period before referral hospital, if necessary.
Awiti said effective management of birth-related complications is essential for reducing maternal and postnatal deaths.
He said presence of a Skilled Birth Attendant at every birth is considered the optimal strategy for reducing maternal deaths.
"Despite several problems in accessing SBAs, such as physical, financial and cultural barriers, my government works closely with health stakeholders and partners towards reducing the maternity deaths,” Awiti says.
In his second-term manifesto, Awiti says one of the projects he would implement is fighting the negative health indicators that have dogged the county.
“We expect to see a positive change in HIV infections, increased hospital visits for expectant women and most importantly, food security, because a healthy county is a wealthy county,” Awiti said.