During a recent forum to offer free sensitisation to mothers on matters pregnancy, labour and childbirth, a first-time mother confessed that she didn’t know that women needed to take folic acid supplementation three months before getting pregnant. This confession opened a lid on the perennial information gap that exists among mothers, their partners and those planning to become parents when it comes to antenatal and postnatal care.
In this forum, dubbed Mommy and Baby Fair, organised annually by The Nairobi Hospital, more than 300 mothers and their nannies from different socioeconomic backgrounds attended the free training sessions about pregnancy care, pain relief options in labour, childbirth, lactation, immunisation, nanny training, nutrition for mothers and myths surrounding pregnancy and delivery.
But why is the focus on the mother important? The third UN Sustainable Development Goal is to ensure healthy lives and to promote well-being for all persons at all ages. Specifically, with regard to maternal health, the goal is to reduce maternal mortality ratio to less than 70 per 100,000 live births.
According to the World Health Organization, global maternal mortality ratio in 2020 was 223 per 100,000 live births. Almost 95 per cent of these maternal deaths occur in low and lower middle-income countries, with 70 per cent occurring in sub-Saharan Africa and this is where we belong as a country. In Kenya, the maternal mortality ratio in 2020 was 530 per 100,000 live births. This is a 7.7 per cent improvement from the year 2000 when it was 564 per 100,000 live births.
The United Nations Population Fund says that Kenya’s maternal mortality ratio, the number of women dying of pregnancy-related causes, stands at 355 deaths per 100,000 live births. This means that there are nearly 5,000 women and girls dying annually due to pregnancy and childbirth complications. While access to skilled birth attendance has improved from 62 per cent to about 70 per cent over the last seven years, more than 80 per cent of maternal deaths are attributed to poor quality of care.
Research has revealed that causes of preventable maternal deaths can be classified into three, namely, delay in deciding to seek healthcare, delay in reaching a healthcare facility and delay in delivery of quality health care at a facility.
This means that for maternal morbidity and mortality rates to reduce in Kenya, increased access to affordable and quality maternal care, including family planning services for our mothers is critical. We also need sustainable financing to strengthen our health systems so as to empower our mothers before and after childbirth.
There is a ray of hope though a lot more needs to be done. The 2022 Kenya Demographic Health Survey Report indicates that 98 per cent of women reported receiving antenatal care from a skilled health provider with 66 per cent attending four or more antenatal visits. This could be one of the strategies that has caused a decrease in cases of maternal mortality.
The WHO advocates that a pregnant woman should have at least four antenatal visits during her pregnancies. Antenatal visits are important to diagnose a woman if she has any condition or assess her to determine whether she is at risk for anything and implement strategies to prevent it in good time.
As we implement the universal health coverage to benefit all Kenyans, deliberate programmes and strategies targeting mothers, expectant mothers and those planning to become mothers are necessary to ensure universal access to patient-centred, skilled midwifery care to end preventable maternal and perinatal deaths. We will cover sufficient ground if these programmes target particularly the marginalised segments of our society in informal urban settlements and rural areas.
I urge all healthcare facilities, public and private, to follow suit in building capacity of our mothers by providing them with quality antenatal care and also more importantly, preconception care to help end preventable maternal and perinatal deaths. We can do it.
The author is a consultant obstetrician and gyneacologist at The Nairobi Hospital. She can be reached on [email protected]