Why new Taita hospital targets child, maternal care

In January this year, Janet Mzae, a nurse at Moda Mbogho dispensary in Mwatate, Taita Taveta County, died soon after giving birth to her first child at Moi County Referral Hospital in Voi.  

Even though she had doctors around her to try to manage her high blood pressure, the 28-year-old succumbed due to lack of specialised care for such cases at the facility.  

Her death illustrates how she was failed by the same healthcare system she worked in.  

At 36 weeks, Scolastica Waleghwa, 37, was expecting a normal delivery of her second child. She was healthy.  

Throughout her pregnancy, Ms Waleghwa, a clerk at the Voi Birth and Death Registries office, was careful about her diet and prenatal care. 

A few days later, she started spotting and her husband, Francis Mdawana, took her for a checkup at the nearest private facility in Voi town. 

"There were no problems until that day, when she called to tell me that she felt something was wrong," Mr Mdawana said. 

A few hours after having a stillbirth at the private facility on December 18, 2021, Ms Walegwa was also declared dead from postpartum hemorrhage, one of the most common causes of maternal deaths.  

"Within hours, she bled and she had to be rushed to Moi County Referral Hospital and was immediately taken to the theatre. It was too late," he said. 

Ms Mzae and Ms Waleghwa are not alone. 

Maternal mortality cases continue to be reported across Taita Taveta. In 2021, eight women died while giving birth in public facilities in the county.  

According to the 2022 Economic Survey from the Kenya National Bureau of Statistics, Kenya's maternal mortality ratio (MMR) is 355 deaths per 100,000 live births, down from 600 maternal deaths per 100,000 live births in 2013. 

Health experts say at least 60 per cent of pregnancy-related deaths are preventable as calls to address maternal mortality continue across the world.  

Global maternal mortality estimates indicate that the majority of maternal deaths occur in developing countries.

They show that about two-thirds of these deaths take place in sub-Saharan Africa.  

One of the targets for Sustainable Development Goals (SDGs) signed by UN member states in 2015 is to reduce the global maternal mortality ratio.

SDG3 aims at cutting maternal deaths to less than 70 for every 100,000 live births by 2030. 

Concerned about the state of maternity care in Taita Taveta, Ms Jeane Bishop, a midwife based in Sydney, Australia, is putting up a state-of-the-art hospital in Voi to provide quality care for pregnant women and their newborns. 

Located in the Mariwenyi area, Grace Maternity Hospital will help fight the rate of maternal deaths in the county. 

Ms Bishop said obstetricians and midwives at the facility will be qualified and will use research-backed protocols to care for both the mothers and their newborns and prevent deaths. 

"I want the hospital to be a model for other facilities not only in Kenya but across Africa. To prove that it is possible to have zero maternal/neonatal deaths and restore the dignity of women in this continent," she said. 

Her vision for such a hospital, she said, started when she was young and was rekindled when she visited Kenyatta National Hospital in Nairobi as a student. 

During her visit, she met a woman recuperating in the maternity ward who told her she had lost five children during childbirth. She was from Taita Taveta.  

"She looked mentally disturbed. I was 18 years old but I knew this was the right time to start the project to save such women. I decided to set it up here," she said. 

After she returned to Sydney, she talked to her father, who helped her to achieve her dream of putting up the facility. 

"Throughout my studies, I have focused on midwifery because I wanted to learn about the challenges facing African women during childbirth," she said. 

Some of the challenges, as Ms Bishop sees it, are postpartum hemorrhage, lack of access to skilled birth attendants, and lack of quality antenatal care. 

But many of these problems could be prevented if hospitals would standardise the way they care for the women, she said.  

"The majority of deaths are from conditions that could have been prevented had women received the right medical care throughout their pregnancies and during birth," she said.  

She said that during her research, women shared their ordeal at the hands of healthcare providers during childbirth. 

"They told me that some midwives disrespect and abuse women during childbirth. The women experienced physical and verbal abuse, as well as being ignored and neglected when birthing at public and private facilities," she said.  

She said there's a shortage of trained medical staff who can identify underlying issues that could cause complications in pregnancy, childbirth or the postpartum period. 

Besides quality services, the hospital will offer special training to their medics to build their expertise in saving women's lives. 

"Unless we address these problems, we will continue to lose women as a result of pregnancy complications and childbirth,” Ms Bishop said. 

"That is why women from well-to-do families travel outside the county and sometimes outside the country to give birth."

Although the first phase of the facility is yet to be completed, Ms Bishop is now calling on the community to embrace the project so that it can kick off.  

She says the hospital, being built on four acres, will have the best equipment. 

"Everything ranging from the maternity beds to the incubators will be top-notch because we want to give the best services. This does not mean that the services will be expensive. The hospital is for all women from all social backgrounds," she said.  

The first phase of the project has a ready theatre, a placenta pit, a prenatal clinic room, a birthing room, and a ward but lacks water, a laboratory, a mortuary, a laundry area, and a kitchen.  

The second phase of the project will comprise six self-contained birthing rooms where the woman will be allowed to be accompanied by their families for support. 

"I'm asking the community to carry the dream because I'm unable to complete the project by myself. The hospital will be a community initiative, I'm just the vision bearer," she said. 

County Director for Health Services Elvis Mwandawiro said statistics from the department reflect progress in preventing maternal deaths in the county.  

"There has been a drop, which is a big step. The maternal indicator is not as bad as it used to be. We audit all cases that happen," he said. 

He said most mothers die due to home delivery, eclampsia or hemorrhage. 

He said the department, through community health volunteers, has been raising awareness among women about the importance of seeking medical attention during pregnancy and childbirth. 

They have also offered training to health workers on emergency obstetric and neonatal care and encouraged blood drives to help patients who need transfusions. 

"We have more gynaecologist consultants in the Moi and Taveta hospitals. We have skilled birth attendants in most of our facilities," he said. 

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