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Why free maternity services could endanger mothers’ lives

Health & Science

By ALLY JAMAH

KENYA: Among the signature initiatives of the Jubilee government in the past 100 days is the waiver of maternity fees in public health facilities.

The initiative has seen the number of expectant mothers seeking the crucial service skyrocket to historic levels. But as expectant mothers continue smiling all the way to hospitals, nurses who are the midwives in public hospitals, are lamenting that their workload has quadrupled while their pay and allowances remain stagnant and hospitals understaffed.

A midwife at Kiambu District Hospital told The Standard, off record since she is not authorised to speak to the media, that nurses in the hospital are working overtime to help mothers deliver, ever since President Uhuru Kenyatta announced the waiver of maternity fees on June 1.

“We have a lot more mothers to help deliver these days but our number is still the same. Most of the time, we are three nurses who have to aid more than 20 mothers. We are unable to supervise the delivery of all mothers effectively,” she said.

She added: “I’m committed to my work but honestly, my morale is very low at the moment. We are doing so much work but the Government has not increased our salaries and allowances,” she said.

On his part, Nurse Evans Nasebe, who is also the Head of the Health Chapter of the powerful Kenya Union of Civil Servants said that for the free maternal healthcare to succeed, the Government should motivate nurses by implementing the raft of allowances they agreed to pay last year.

Nasebe said the allowances that should be implemented include night duty (Sh30,000 per month), high-risk (Sh15,000 per month), Non-practising (Sh15,000 per month) and uniform (Sh20,000 per year)

He added many mothers are forced to leave the hospitals within 24 hours before they have fully recovered to accommodate other expectant ones.

He also lamented the shortage of birth packs for expectant mothers in public hospitals forcing nurses to improvise adding some are also giving birth on the floor.

Critical equipment

“It is not enough that expectant mothers are going to public facilities to give birth, but we should ensure they are getting safe and quality services. But with the current scenario many mothers are still at high risks due to shortage of staff and critical equipment,” he said.

National Nurses Association of Kenya Chairperson Jeremiah Maina, who is also a nurse, said the free maternal healthcare risks failure if the Government does not significantly increase the number of midwives in public hospitals. He said that the 14,000 nurses the Government is far too low as 60,000 are required.

According to World Health Organisation, Kenya has 13 per 10,000 trained midwives/doctors/nurses against the recommended 23 per 10,000.  “In most cases, you may find that one midwife is handling more than 20 mothers at a go. Even if you remove the charges, you have not solved much of the problem since the requisite number of well-trained personnel is not there,” he said.

Strategic Communications Advisor at Program for Appropriate Technology in Health Oby Obyerodhyambo said that doing away with the maternal health charges may not impact much in reducing maternal deaths as many public facilities that offer free maternity services are far from rural areas.

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