Kenya: Trained Traditional Birth Attendants Answer To Reducing Maternal Mortality?
A huge banner at the Ministry of health, Division of Reproductive Health, boldly says that no woman should die while giving birth in Kenya. While giving life should be a moment of intense happiness, childbirth in most cases is associated with pain, injuries, complications and even death. Research portrays a grim situation of the state of maternal mortality in Kenya. That 21 women die daily while giving life or as a result of pregnancy just shows how far we are from realizing MDG 5.
The government in a move to reduce these crushing figures made a free maternity declaration, to ensure that cost is no barrier. With this attempt, there was belief that home deliveries, which contribute heavily to maternal mortality rates, would drop. However, the choice for home deliveries seems to be more than just as a result of financial limitations. In Busia County for example, a recent survey revealed that about eight out of ten women prefer to give birth assisted by traditional birth attendants as opposed to visiting hospitals. The situation is not that different in Kibera, a slum in the capital city of Nairobi. Pregnant women would rather make a longer trip to ritual prayers, traditional healers, and midwives as opposed to visiting closer hospitals. The main reason was perceived to be due to hostility and poor attitude by service providers at these hospitals.
Traditional birth attendants are as old as pregnancy itself and thus its an institution that is here to stay. It is therefore imperative that governments build the capacity of traditional birth attendants to enable them do their duties with professionalism while recognizing the dangers that lurk in the dark waiting to pounce.
With the onset of devolution in Kenya, counties have much to say in the administration of the public health sector. In Nakuru county for example, the county government tabled the County Maternal, newborn and child health Bill that among others intends to train traditional birth attendants and ensure they are able to midwives delivery in an environment that is not only safe but enjoys the confidence of the public and the government. Such initiatives by county governments are likely to go a long way in ensuring that maternal morbidity and mortality face towards zero.
Traditional birth attendants can be that bridge between a struggling healthcare system and the promise of a better future for our mothers. Training traditional midwives will also enable them to leverage on rapidly growing technology.
In Kibera slums, due to the works of civil society organizations such as Amref Health, traditional birth attendants without any formal education are able to save lives while getting prompts from their mobile phones and confer with each other, make referrals, give important advice to pregnant mothers and even do follow ups. Such apps also stress on exclusive breastfeeding, nutrition for mother and make it possible for pregnant women in emergencies to contact community health volunteers and get referrals.
With slum areas like Kibera that have a high annual pregnancy rate of about 800 women, such initiatives will go a long way in not just ensuring safe deliveries but enhancing best practices even after successful deliveries.
Midwives who had traditionally been feeling inadequate and feared government antagonism have now gotten fresh impetus to do what they have always been doing but better and with more gusto and confidence. They feel that with passion and a little training and enthusiasm they are more empowered to save lives.
Even as government leaders look into the curriculum at medical training colleges to train more skilled birth attendants, there is need that as long as some women are still giving birth at home, the capacity of traditional midwives to conduct such deliveries should be without a shred of doubt. That’s if we are to close in on the fifth millennium goal.
Photo Credit: HuffPost
