How to deal with high death rates

In June 2014, the Philips Community Life Centre (CLC), based in Kiambu County, opened its doors to the public. The facility, whose standards match those of referral hospitals, offers what Philips describes as a community-driven, holistic approach to improving primary healthcare. The CLC is not just a health facility. It is also a community hub.

The Solar PV system installed by Philips provides reliable and clean energy supply to the centre while the indoor and outdoor LED-lighting enables extended operating hours and provides security to patients and staff.

The CLC also boasts of advanced medical devices for improved patient monitoring, diagnosis and triage; laboratory equipment; refrigeration for vaccines and medicines. It also has IT solutions for efficient operation of the clinic, connection with the community and the rest of the healthcare system as well as an efficient water supply and purification system to prevent waterborne diseases.

Partnerships

One of the interesting aspects is the sustainability aspect. The facility sells water from its water supply and purification system to the local community and the proceeds from the sales are ploughed back to healthcare provision, ensuring sustainability.

The CLC is proof of a number of things, but primarily, it demonstrates the power of partnership. The CLC demonstrates that healthcare need not be too expensive or complicated. The technology is available and there are many potential partners out there. What is required is an innovative spirit, political will and integrity in the management of healthcare. The CLC also shows us that infant and maternal mortality can be reduced considerably by taking quality healthcare closer to the people.

Estimates from 2016 showed that infant mortality rate was 38.3 deaths per 1,000 live births with male infants accounting for 42.7 deaths per 1,000 live births and female infants 33.7 deaths per 1,000 live births. Compare this with 115 deaths per 1000 live births in 2003 and 77 deaths per 1000 live births in 2008. Sustainable Development Goals   (SDGs) #3 therefore, places emphasis  on infant and maternal mortality with good reason. The targets are ambitious but attainable if we can be deliberate about our priorities.The aim is to end preventable deaths of newborns and children below 5 years of age by 2030, with all countries aiming to reduce neonatal mortality to at least 12 deaths per 1,000 live births and under-5 mortality to at least 25 deaths per 1,000 live births.

Maternal mortality ratio, on the other hand, is the number of women who die during pregnancy and childbirth, per 100,000 live births. The SDG goal is to reduce the global maternal mortality ratio to less than 70 per 100 000 live births by 2030. 2015 estimates indicate that Kenya’s maternal mortality ratio stood at 510 per 100,000 live births.

We must invest significant resources in building and equipping health facilities. Ideally, every ward should have a health facility with the capacity to handle complex delivery including caesarian section. Very often, there is little time to transfer an expectant mother who develops complications to another facility, many kilometers away.

Whereas the government introduced free maternal delivery in all public health facilities countrywide, the effective provision of the services have been stifled by a number of factors. One of the factors is the capacity of the health facilities to handle the needs of expectant mothers in general and complex cases in particular.

Our health facilities lack essential equipment, drugs and skilled personnel to offer the critical services that are sorely required. So whereas the free delivery has been appreciated and has actually made a difference, the gaps that exist must be addressed if the third SDG goal is to be met by 2030.

Partnerships are so crucial that it made it to the SDG goals as #17. There is no denying that health care is a primary duty of the government. But everyone acknowledges that given the strength and size of our economy and the competing interests for our limited resources, it is impossible for the government, by itself, to meet SDG #3, or indeed any SDG,  by 2030. Naturally, this calls for partnerships.

We must recognize the role of mission and faith based health service providers. They have historically played a critical role and it is impossible to imagine health care without them. But it is now time to re-imagine their role within a framework of mutual partnership.

Creativity

Then there is the role of business, not just those directly involved in healthcare but every profit making business operating in the country.

Think about employers creating less stressful working environments for their employees, media companies creating awareness and holding duty bearers to account, agricultural and food companies making nutritious foods available to low income and vulnerable segments of our population and pharmaceutical companies making cheaper drugs available to mobile clinics that serve remote communities. Basically, business should innovate to make health care accessible and affordable to all.

What we must remember is that we don’t have an option of doing nothing. If we stay away, we shall still be impacted by the failure of others. To create a sustainable, inclusive and future -proof world, we must step out of our comfort zones, innovate and impact our communities.

Ms Boomsma is Coordinator, Sustainable Inclusive Business  (Kenya) based at KEPSA.@karin_boomsma