Safe deliveries are beyond the reach of women in many parts of the world. In the Nyando district of Nyanza Province in western Kenya, only 35 percent of women deliver at health facilities and the national average of hospital deliveries is just under 50 percent. Without sound medical care and counseling, pregnant women and their babies are at a higher risk of suffering from complications and missing opportunities to prevent mother-to-child transmission of HIV. Nyanza Province has an infant mortality rate of 92 per 1,000 and maternal mortality of 660 per 100,000 live births, the highest such mortality rates in Kenya. It also has an HIV prevalence of 14 percent, the highest in the country.
Many health facilities in the region are not easily accessible or appropriately equipped, and services are often too costly. “I delivered three children at home since the hospital was very far and I could not afford transport,” said Lorine, a mother of four children who comes from Nyalenya village in Nyanza Province. Similar sentiments were echoed by Mary, a 23-year old mother of four. “I live 200 meters from the local health center but since it was not offering maternity services, I delivered three children at home. I could not afford the cost of delivery at the nearest private hospital.”
Despite a busy antenatal care unit with 325 new patients in 2011 alone, the Chemilil Health Center—a small facility in the sugar-growing region of Nyanza Province—lacked space, basic equipment, and trained staff required for providing maternity services. Pregnant women in labor were referred to Muhoroni Sub-District Hospital located approximately 20 kilometers away. Many pregnant women could not afford the fare for public transportation to the hospital and were forced to deliver at home.
Recognizing the critical need to provide pregnant women access to obstetric care, ICAP is committed to improving safe hospital deliveries in the Nyanza health system. In partnership with clinics throughout the region, ICAP has helped to ensure that these health facilities are properly staffed around the clock, equipped with basic obstetric delivery equipment, and are offering services such as training and mentorship for staff and expecting mothers.
At the Chemilil Health Center, ICAP began supporting prevention of mother-to-child transmission of HIV programs and HIV treatment services in 2010, and more recently has supported the provision of basic emergency obstetric and 24-hour delivery maternity services. Prior to adding these delivery services, ICAP collaborated with community leaders, district health management teams, and hospital teams to renovate the Center, creating a new delivery room and a place for night staff to sleep. A pit was also constructed for sanitary disposal of obstetric waste. Necessary obstetric equipment—such as a suction machine, portable electric lighting, and delivery kits—were also provided to the Center.
In May 2011, Chemilil Health Center began its 24-hour maternity services and the first woman delivered there that same month. Community dialogue meetings were also held following the launch of the renovated center, providing information to women in the community about the new services and to highlighting the importance of facility-based deliveries. Since then, the number of deliveries has doubled each month and, by the end of February 2012, the facility assisted the delivery of 62 women.
“I am now happy since I am able to get services at Chemilil Health Center that I can afford. They also provided me with a cup of tea and warm water for washing after delivery,” said Lorine.
To date, ICAP in collaboration with the Ministry of Health has renovated 20 maternity units and continues to work towards the goal of reducing maternal and infant mortality in Nyanza.
“Safe motherhood will only be achieved when delivery services are decentralized to the primary health care facilities. By renovating, equipping, staffing, and engaging the communities, I have witnessed a tremendous increase in hospital deliveries at ICAP-supported sites in Nyanza Province. This is a sure way of achieving the Millennium Development Goals 4 and 5, which aim to reduce maternal and child mortality,” Dr. Eliud Mwangi, program director in ICAP’s Kenya office.