Kipyegon, governors flag off run to end maternal deaths

Olympic gold medalist Faith Kipyegon (second left) with Governors Gladys Wanga, Susan Kihika at the End PPH Run in Nairobi. [@TheKOGSociety, X]

The first-ever run aimed at addressing maternal mortality took place in Nairobi, graced by Olympian and 1,500 metres world record holder, Faith Kipyegon.

Then race, dubbed End PPH (Postpartum haemorrhage) Run, sought to highlight maternal mortality in the country, with about 15 women losing their lives to pregnancy related complications every day in Kenya.

“As a female athlete, and a mother, I am conscious of the challenges and risks women face daily. Losing life whilst giving a life should not be something we face in the modern world,” Kipyegon, who is the ambassador of the run said.

Other notable attendees were governors Susan Kihika ( Nakuru), Cecilly Mbarire(Embu) and Gladys Wanga (Homa Bay). Former Chief Justice David Maraga was among key dignitaries.

“This run is important because it is about saving the lives of our mothers. We must do everything to make sure that Kenyan mothers are safe and receive the best possible healthcare through pregnancy and also during delivery,” Mbarire said in a speech on behalf of the governors.

PPH refers to excessive bleeding from the mothers’ birth canal after childbirth.

“PPH can occur immediately following birth or later,” said Prof Moses Obimbo, an obstetrician and gynaecologist and a don at University of Nairobi’s School of Medicine.

“Primary PPH occurs within the first 24 hours, while secondary PPH occurs after 24 hours up to the first six weeks,” he added.

Maternal mortality — the annual number of female deaths from a cause related to or aggravated by pregnancy — is perpetuated by five main causes They are: PPH, sepsis, post-abortion complications, hypertensive disorders and obstructed labour.

Of the five, PPH is the deadliest and is recognised as the leading cause of maternal mortality globally.

In Sub-Saharan Africa, PPH accounts for between 30 and 50 per cent of maternal deaths. In Kenya, the number is said to be between 25 and 45 per cent.

“On average, out of every 15 women who die during childbirth in Kenya, about four are due to PPH,” said Dr Kireki Omanwa, the president of Kenya Obstetrical and Gynaecological Society.

According to World Health Organisation, more than 14 million women experience PPH resulting in about 70,000 deaths each year.

Even so, the risk of PPH and PPH related deaths is higher in Low- and Middle-Income Countries (LMICs), with Sub-Saharan Africa and Southern Asia accounting for about 85 per cent of the global burden.

According to the Ministry of Health, Tana River, Garissa, West Pokot, Elgeyo Marakwet, Machakos, Homa Bay, Siaya, Wajir, Kilifi, Muranga, Makueni, Migori and Turkana counties have the highest number of PPH related deaths.

In these counties, high PPH rates are attributed to inadequate access to skilled healthcare providers, limited availability of essential medical supplies and equipment, and gaps in emergency obstetric care.

Many factors affect PPH outcomes for many delivering mothers.

“There are patient factors such as failure to attend antenatal clinic (ANC), and healthcare worker factors such as inadequate skills to respond effectively to PPH,” said Dr Omanwa.

However, administrative factors such as inadequate hospitals, poor road networks, absence of ambulance services, poor supply of equipment, medicines and medical facilities, insufficient cold storage for medicines, blood transfusion services, and substandard drugs, are noteworthy across all LMICs.

Data shows that many high-income countries are experiencing single digit rates with under 10 deaths per 100,000 live births.

 In Kenya, maternal mortality is officially at 355 deaths per 100,000 live births. However, according to a United States Agency for International Development report on preventing child and maternal deaths, the number is 594 deaths per 100,000 live births.

PPH usually occurs when the uterus does not contract sufficiently after birth.

“Bleeding can also occur when there is retention of placenta, fetal membranes or blood clots,” says Dr Omanwa.

Other scenarios are tears or lacerations of the birth canal, and when a mother has abnormal blood clotting mechanisms in her mother’s body.