HIV/AIDS & Reproductive Health

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Source: Daily Nation
The day of a child's birth should be a day filled with joy, but for many Kenyans, it is a day of fear.

For the most unfortunate, it is a day of tragedy.

For Atieno, a woman living in western Kenya, the fear lasted for days. She laboured for more than 72 hours at home in her rural village. There was heavy bleeding and when Atieno finally delivered her daughter, it was without the help of a skilled birth attendant or life-saving products such as oxytocin to stop bleeding.

Both mother and baby were fortunate. They survived one of the riskiest experiences a woman and her child will face: childbirth.

While Atieno and her baby survived, too many others do not. As doctors, we hear and see these stories every day. One in 38 Kenyan women is at risk of dying from childbirth complications such as excessive bleeding or obstructed labour.

Every woman and child deserves high-quality health care, but there are glaring gaps in the care people receive across our country.

We can change this. Kenya's doctors are calling on our leaders to create a comprehensive national legislative framework to improve the health of women and children and end preventable deaths.

Kenya has the second-highest rate of stillbirths in East Africa. And our newborns face grave challenges such as being born prematurely, losing oxygen during birth, and contracting deadly infections such as sepsis after birth. For those who survive their first days of life, threats such as pneumonia, diarrhoea, and malaria continue throughout childhood.

Children born in western or northern Kenya are less likely to celebrate their fifth birthdays than those born in central Kenya, according to the 2014 Demographic Health Survey.

KENYA MAKING PROGRESS

The good news is that Kenya is making progress, and we can build on this. The Vision 2030 development blueprint provides for affordable, accessible, and quality health care for all citizens.

In 2013, the Ministry of Health launched a free, nationwide, maternal care policy in public hospitals across the country, and the First Lady's Beyond Zero campaign is working to increase care during pregnancy and after childbirth.

The recent launch of the government's maternal and neonatal health implementation plan is another important step in the right direction.

But the work is far from done. We need comprehensive policy action at the national level and in every county.

There are three things we can do now to improve the lives of Kenya's women and children.

First, we must invest more in maternal, newborn, and child health and in health system strengthening. This means investing in products and people. Lifesaving products that prevent and manage maternal bleeding and thwart infection of newborns' umbilical cords must be prioritised and funded.

To achieve lasting change, investing in and strengthening entire health systems, from the health care workers to the accessibility of hospitals, clinics, and services, must be prioritised.

Second, we must ensure accountability. Government agencies providing health services or products need clearly defined responsibilities. Agencies must understand each other's roles and unique contributions through better communication and coordination.

We need greater reporting of the measures of progress -- such as the number of births attended by a skilled attendant or children vaccinated -- to inform decision-making. Having this evidence will enable Kenyans to hold decision-makers accountable for their responsibilities.

SKILLED ATTENDANTS

Third, we must increase access to high-quality services in every county because childbirth and the early days of life should not be filled with fear. Women need reliable access to care before pregnancy, throughout pregnancy, during childbirth, and following it, no matter where they live.

Skilled attendants must be part of childbirth. Emergency obstetric and newborn care are essential for the health of mothers and their newborns in every county. A woman in Marsabit or Turkana deserves the same quality of care as a woman in Mombasa or Nairobi.

Achieving Kenya's health care goals will require a collective effort. It will require health providers to deliver care, political leaders to support policies investing in health, civil society organisations and advocates to support these policies, and entire communities to value the health of mothers, babies, and children.

A comprehensive national legislative framework focused on maternal, newborn, and child health is critical to ensure that our mothers, wives, sisters, and daughters get the care they need. Such a framework will guide implementation, set standards, designate responsibilities, and increase coordination and accountability.

Kenya has the opportunity to lead the continent by ending preventable maternal, newborn, and child deaths.

Dr Kariithi is a senior service delivery technical adviser at PATH. Dr Okoro is a sexual and reproductive health programme officer at the United Nations Population Fund and a member of the Maternal, Newborn and Child Health Legislation Task Force.

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