Threat of maternal and newborn deaths still a reality

Maternal and child health shapes a society’s or country’s future, given its inter-generational impacts. Research has proved that there exist socioeconomic benefits of investing in women’s health.

Of critical concern is proper care during pregnancy and childbirth. This is crucial to the health of both mother and child. The Constitution, under the Bill of Rights, exemplifies this when it recognises that “the life of a person begins at conception,” demonstrating the essential role of pregnant women in protecting the rights of the unborn.

For a long time, high maternal mortality rates evinced dysfunctional systems that could not respond to women’s needs. This was – and remains – a major problem in low-resourced countries. It, in part, formed the basis of the United Nations Sustainable Development Goal 3, which seeks to ensure healthy lives and promote wellbeing for all at all ages. Its first target is to reduce the global maternal mortality ratio to below 70 per 100,000 live births by 2030, underscoring how central maternal health is to overall health and, by extension, sustainable development.

To achieve the goal, Kenya, through devolution, must play its part. It’s been a decade since the country adopted the devolved system of government, marking a momentous shift in the management of healthcare services. The counties were created to take services closer to the people.

Previously, the national government was in charge of every aspect of the health function. However, with the coming into force of the 2010 Constitution, it only retained the policymaking mandate and the management of level 6 (national referral) hospitals.

The current health structure has six levels and the counties control the first five: community services (level 1); dispensaries (level 2); health centres (level 3); sub-county hospitals (level 4); and county referral hospitals (level 5).

The counties, therefore, are key custodians of the healthcare function. They must help the country to rewrite its maternal health story through accessible and affordable quality services, including institutional delivery, perinatal care, and emergency care.

Although key maternal health and childcare indicators point to progress, the devolved units must further strengthen their health systems and provide the needed material and human resources for better outcomes.

The threat of maternal and newborn deaths—due to negligence, inadequate staffing and poor systems and infrastructure—still rears its head and should particularly be an area of interest if desired results are to be realised. As part of their interventions, the counties should prioritise emergency transport and referral systems, equipment, adequate skilled personnel, maternity waiting rooms, and communication mechanisms for turnaround. Health workers at the lower levels also ought to be empowered to offer emergency services.

Not forgetting technological innovations that will continue to drive maternal and child health improvements, the county governments should keep abreast and take advantage of such changes to tackle current and emerging challenges—including inequalities that have adverse effects on health outcomes—for the benefit of the people.

No matter their limitations, they have to strive to create a positive experience for mothers during pregnancy, delivery and the postnatal period. Only then can they remain true to the women and provide a platform for societal change.

This week, Nation.Africa continues its series of the good, the bad and the ugly of devolution for the Kenyan women and girls. Read Ten years on: Status of maternal healthcare in counties.

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