Maternal health remains a critical challenge in several counties across Kenya, and Bungoma is no exception. The county has, in the past, recorded preventable maternal deaths linked to pregnancy and childbirth complications, often attributed by health experts to delayed diagnosis and limited access to timely specialised care.
However, a new medical innovation is now reshaping how maternal health services are delivered, offering renewed hope for expectant mothers and healthcare providers alike.
The introduction of Point-of-Care Ultrasound (Pocus) is transforming maternal healthcare by enabling frontline health workers to quickly detect life-threatening conditions, make timely decisions, and initiate appropriate interventions, ultimately saving the lives of mothers and their babies.
Among those whose lives have been positively impacted is 37-year-old Lydia Chebet from Kapendo village in Mt Elgon Sub-county.
She recalls the anxiety and uncertainty she experienced when complications were discovered during her twin pregnancy.
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“Talk of the anxiety and uncertainty I faced after health workers discovered complications in my multiple pregnancy,” said Chebet.
Following the diagnosis, a POCUS scan was conducted, and medical staff recommended that she undergo a caesarean section (CS), a surgical procedure in which a baby is delivered through incisions made in the abdomen and uterus.
Accepting both the diagnosis and the recommended mode of delivery was not easy for Chebet, particularly because the portable ultrasound technology was unfamiliar to her.
Like many expectant mothers in rural areas, she initially doubted its accuracy and feared undergoing surgery.
She spent nearly a week in the labour ward, where healthcare providers closely monitored her condition and repeatedly explained the risks associated with her pregnancy.
Despite their advice, she remained hesitant to consent to the surgery, hoping she could deliver normally.
“At first, I didn’t accept the Pocus results because it seemed to be a new machine that I had never seen or used before. While at Cheptais Sub-County Hospital, I decided to seek a second opinion and went to Sirisia Sub-County Hospital for another ultrasound. The results were the same as those from the Pocus scan,” she said.
The matching results reassured her that the concerns raised by health workers were valid and that the recommended intervention was necessary to safeguard her life and that of her babies. Even so, the thought of undergoing a caesarean section remained frightening.
“I was worried about undergoing a CS because I had never had one before, and I feared the operation,” she said.
Healthcare workers took time to counsel her, explaining how the scan had revealed complications that could endanger both her and her babies if she attempted a normal delivery.
Through continuous education and reassurance, she gradually gained confidence in the medical team’s advice.
“After I was enlightened about Pocus and the reasons why a caesarean section was necessary, I accepted and underwent a successful CS. Today, my twins are healthy and growing up well,” she said.
According to reports from the Kenya National Bureau of Statistics (KNBS) and the Ministry of Health, Bungoma County’s maternal mortality ratio stands at approximately 385 deaths per 100,000 live births.
Improved services
At the Bungoma County Referral Hospital (BCRH), maternity unit in-charge Dinah Khaemba said the introduction of Pocus has significantly improved service delivery at the facility.
She explained that previously, expectant mothers requiring ultrasound scans had to be referred elsewhere, often leading to delays and logistical challenges.
“Before the adoption of the Pocus machine in our maternity section, we had to arrange an ambulance to take clients for ultrasound services at the main hospital, where there were often long queues and delays,” she said.
She noted that the new technology has made diagnosis faster and more efficient.
“Pocus has its limitations in that it is not that detailed, but it helps us assess foetal heartbeat, position, number of babies, placental condition, estimated weight, and amniotic fluid levels,” she explained.
“When a more detailed scan is required, we refer the mother to the main hospital for advanced imaging services,” she added.
Khaemba added that the Point-of-Care Ultrasound initiative is spearheaded by the AMPATH programme and aims to bring real-time imaging services closer to rural and underserved communities.
The initiative is designed to bridge critical gaps in maternal and newborn healthcare by enabling frontline health workers to conduct timely scans, identify complications early, and make faster clinical decisions.
By reducing the need for long-distance referrals, Pocus has improved access to care, strengthened referral systems, and enhanced decision-making among health providers.
Saving lives
She noted that the technology is helping save lives by ensuring expectant mothers receive timely interventions, particularly in areas where access to specialised diagnostic equipment and personnel has traditionally been limited.
“This point-of-care ultrasound initiative is a result of the partnership between Bungoma County Referral Hospital and AMPATH,” she said, commending the organisation for the innovation.
At the facility, four healthcare providers have already been trained to operate the machine, and the service is offered free of charge to expectant mothers.
“Our clients do not pay for Pocus, unlike the conventional ultrasound services at the main hospital,” she said.
She further noted that the machine is also useful in assessing other conditions, such as breast tumours and heart-related complications.
Khaemba added that Pocus is particularly valuable in managing emergency cases such as eclampsia, enabling rapid clinical decisions.
“Once we conduct a POCUS scan, we can immediately decide on the appropriate care. If an ultrasound is needed urgently, it is done without delay because we have a maternity theatre within the unit,” she said.
She acknowledged that eclampsia remains a leading cause of maternal deaths in the county. However, she noted that since the introduction of Pocus, maternal deaths have declined, with the county recording 10 deaths since January.