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Gifted hands that midwife deliveries

Min Jossy attends to even doctors and nurses in Homa Bay

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by Robert Omollo @robertomollo3

Africa12 June 2019 - 17:51
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In Summary


• 'Attitude' of medics in public hospitals keeps traditional birth attendants in demand

• Inspired by one, Homa Bay included community health workers in healthcare plan

Traditional birth attendant Petty Akoth shows documents of children who have been delivered at her home ‘clinic’ in Sofia estate, Homa Bay town, on May 7

At 71, Petty Akoth still receives a lot of women who come to deliver babies at her Junction Kodoyo home in Homa Bay town.

The revered traditional birth attendant has more than 60 years of experience in helping women deliver live births without a problem.

At the age of 15, Akoth, who is commonly known to residents of Homa Bay and beyond as Min Jossy (Mother of Joseph), had begun attending to many women of different backgrounds, including professionals and the illiterate.

Min Jossy helps at least five women to deliver their young ones at her home every day.

The most surprising thing is the varying classes and social standings of her clients. Medics including doctors and nurses, who always preach to women to give birth in hospitals, are among her clients.

“Women, including the nurses, come to this my mabati house to deliver their babies. What they tell women at the hospitals are just but routine and government policies, which everybody needs to hear,” she says.

Akoth began her work, which she inherited from her late grandmother, at the age of 10.

She has become famous despite efforts by governments to improve hospital deliveries to reduce the mortality rate of mothers and newborn babies by encouraging pregnant women to deliver in health facilities.

Due to high cover costs and long distances to health facilities, many women still prefer the services of Mama Jossy.

“I’m gifted and what I consider most is life. In my over 60 years' experience, I have always delivered live births without any problem,” she says.

Some clients are those who have undergone Caesarean-section more than twice and are told never to get pregnant again, but I help deliver their fourth or even fifth babies

WHY SHE IS POPULAR

Besides her track record, what lures women to Akoth is her ability to detect whether a woman has the strength to push out a baby or not.

This is especially true for women who are HIV positive and those who are malnourished and hypertensive.

In such cases, she will do most of the work herself, unlike in hospitals, where mothers are harassed into pushing the babies or facing the knife.

“Some clients are those who have undergone Caesarean-section more than twice and are told never to get pregnant again, but I help deliver their fourth or even fifth babies,” Akoth says.

The other gift Akoth has is the ability to make the ‘baby turn its head’ in case it is not yet engaged by the time labour pains get underway, a condition that has led many women to the operation tables.

Pregnant women are put off by the 'attitude' and lack of personalised attention and customer care in many public hospitals. That is why many still troop to traditional midwives despite some living only a few kilometres from public hospitals.

In a month, Akoth delivers at least 60 women, a figure that a single hospital like Homa Bay county referral, which serves as a referral hospital to Rangwe, Mbita, Kendu Bay, Rachuonyo, Ndhiwa and Ramula, cannot boast of.

“I keep records and details of births and certificates of recognition alongside a letter of approval from the area chief that allows me to carry out midwifery duties,” she says.

Her contribution to reproductive health earned Akoth training in sick nursing, midwifery and general first aid by African Medical and Research Foundation (Amref) in 1992.  

In 1998, the Homa Bay County Referral Hospital called for training on how best to handle HIV-positive clients who are still avoiding hospitals.

Delivered babies are given drugs that prevent HIV transmission from mother to child.  

“HIV-positive patients are advised to come with Navirapin syrup, Zidovudine syrup and Lamivudine syrup, which are given to the newborns immediately after tying the umbilical cord to prevent transmission,” Akoth says.

The traditional birth attendant says she can also treat infertility in women and impotence in men, which has earned her many friends.

FRIENDLY PRICES

For Akoth's services, all one needs is a stipend ranging from Sh200 to Sh600, but sometimes she does it for free. She says some mothers are too poor but need help.

“Most of my clients are those who live below the poverty line, hence I consider helping them first,” she says.

Akoth is among many of the community health workers who operate in the county.

A number of the health workers who use herbal medicine treat diseases including yellow fever, diarrhoea, amoeba and skin diseases.

According to NGO Maisha Trust’s survey report, more than 60 per cent of residents visit the community health volunteers for health services.

George Orwel, who worked with the organisation in the county, says most people, especially women and girls, first seek medical attention from the community health volunteers before looking for an alternative.

“The community health workers are reachable due to their proximity apart from how they handle clients,” Orwel says.

In its survey report, Maisha Trust says there are more than 400 community health workers across the county.

It is against this backdrop that Homa Bay government has decided to incorporate community health workers (CHWs) in the sector.

Health chief officer Gerald Akeche says they are employing different modalities to fight the high disease burden, which includes HIV-Aids, malaria, cholera and diarrhoea.

The county mortality rate stands at 194/1000 live births, while that of HIV is 25.7 per cent.

Akeche says the county government has realised the important role community health workers would play in lowering the disease burden.

“More than 60 per cent of residents first reach CHWs for medicinal aid before any health facility because they are on the ground,” Akeche says.

COMMUNITY HEALTH WORKERS

About 200 community health workers in the county have undergone training on basic health skills and their functions.

They are tasked with identifying children for immunisation and urging expectant mothers to attend clinics for prenatal and antenatal care.

The CHWs are assigned to guide residents on basic sanitation at household level and advise on family size. They promote basic nutrition, safe water use and anti-malarial campaigns.

With HIV, CHWs advise on safe condom use, adherence to treatment for infected persons and give talks on abstinence among youths.

Other tasks include humanisation, use of insecticide-treated nets, HIV tests in households, weighing children and prevention of malnutrition.

They also conduct rapid tests on the common diseases before referring the clients to the nearest health facility.

“We’ve realised that these and among others are the common diseases which greatly affect our people and can easily be dealt with at the initial stages. The CHVs will provide primary health care services as they tackle the diseases,” Akeche says.

Health executive Richard Muga said the government has introduced a bill in the Homa Bay county assembly that will enable them to pay community health volunteers a stipend regularly.

In the bill, the county government and partners would source funds through contribution to pay the CHWs.

“Homa Bay government embraced the community health volunteers because they are flexible to enter into households and motivate locals to adopt health-seeking behaviour,” Muga said.

He says the trained CHVs are required to work with qualified health workers of different cadres in county government and partners to achieve the agenda of reducing the high disease burden.

“We believe Homa Bay will make a difference in health indicators. The agenda is in line with the Universal Health Care (UHC) coverage because we’re building the primary health care,” he added.

Currently, there are 260 health facilities in Homa Bay county, serving a population of more than 1.9 million people.

“The county government wants residents’ treatment process to begin at the grassroots. The CHVs are expected to work in accordance with the regulations set within the bill,” Muga said.

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