Poor maternity services put expectant mothers at risk

Deserted maternity wing at Kihingo dispensary in Njoro. The facility has been condemned. September 14, 2017. PHOTO BY KIPSANG JOSEPH

Lack of personnel and equipment are hampering efforts to reduce maternal mortality, despite the free maternity project the Jubilee administration started a few years ago.

Several maternity wings built round the county when Governor Kinuthia Mbugua was at the helm have been deserted, while others are not fully operational.

Expectant mothers in remote areas are forced to walk several kilometres to seek medical services. Some end up in the hands of unskilled birth attendants.

Expectant mothers who attend Marioshoni Dispensary to deliver are usually referred to either Elburgon Hospital located 11 kilometres away, or Molo Hospital. But the maternity wing at Njoro Hospital, with a capacity of 10 beds, does not offer the services.

A nurse at the facility told The Standard that the maternity wing has three nurses, but should ideally have at least six. The nurses dispense drugs, conduct immunisation, accounting work and keep records.

The dispensary, recently upgraded to a health centre, has no electricity, making it difficult to provide maternity services.

“We cannot have a maternity operating without electricity. We have neither a baby resuscitation equipment nor an incubator,” said the nurse, who sought anonymity.

Kihingo Dispensary in Njoro Sub-county has two maternity wings, one constructed by the Constituency Development Fund (CDF), and a new one constructed by the county government. None of them is operational.

The county government is said to have constructed the new facility after establishing that the CDF one did not meet set standards. The wing does not have sluice room (where waste is handled). The walls and floors have cracks.

Condemned before opening

Its construction cost of Sh1 million, and was given five maternity beds and a coach. The facility was, however, condemned by the Public Health department a few days before its official opening. It has only four nurses.

Elsewhere, mothers due for delivery in Nakuru West Sub-county are forced to seek services at Rhonda Health Centre in Nakuru East Constituency or travel to the Rift Valley Provincial General Hospital.

Kapkures and Lalwet hospitals, which were recently upgraded to health centres by the county, do not provide maternity services despite having newly built maternity wings.

Kapkures has a capacity of 20, but it is yet to be equipped with delivery equipment, including an incinerator to dispose of maternity waste.

An employee at the hospital who requested anonymity because he is not allowed to speak to the media on the matter said the maternity wing should be opened to avoid birth-related complications.

According to the employee, many mothers develop complications after failing to receive essential services during birth.

Syprene Odera, a Kenya National Union of Nurses official, told The Standard for effective maternity services, a maternity wing should be manned by at least four nurses.

Overwhelming

Ms Odera said a single nurse can be overwhelmed by procedures necessary during delivery of a newborn, sometimes resulting in complications.

“Maternity is tricky: breathing of the newborn should be checked, and the mother must be monitored, especially to help control bleeding. All this cannot be handled by a single nurse,” said Odera.

She said it was unfortunate that the county constructed maternity wings without consulting nurses who handle deliveries.

The county records 375 maternal deaths per 100,000 births annually, according to a recent report by the Ministry of Health.

In 2016, 65 per cent (or 47,458) of deliveries in the county took place in hospitals.

Governor Lee Kinyanjui has established a health taskforce led by James Tuitoek to look into issues affecting the sector. Prof Tuitoek said most dispensaries and health centres lacked beds and maternity coaches.