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Great strides in Reducing Maternal and Perinatal Deaths in Bungoma County, a model for others.

By Treezer Michelle

“Early initiation of prenatal care by pregnant women, and continuous monitoring of pregnancy by health providers, are key to helping prevent and treat severe pregnancy-related complications,” says Christine Naliaka, the Bungoma County Reproductive Health Coordinator, and the Deputy Chief Nurse in Bungoma County.

According to Christine, it is advisable to attend at least four Antenatal Care (ANC) sessions so that doctors can detect and manage early risk signs during the pregnancy, ensuring that mother and baby are fine.

“During prenatal care, mothers undergo tests to identify underlying medical conditions that can cause maternal or perinatal death. Blood and urine tests are mandatory. This helps in knowing the HIV status of the mother and the presence of any other sexually transmitted infections (STIs). “

Expectant women are also given drugs and injections important during pregnancy and birth period. The drugs include folic acid, iron tablets, anti-malaria injections and anti-tetanus injections.

“Some women are, however, reluctant to come for the four continuous ANC visits during their pregnancy period. Some disappear after one or two visits. There are others who do not attend ANC at all. This increases maternal and perinatal mortality as possible complications during birth are not identified in time,” explains Christine.

According to Reproductive, Maternal, Newborn, Child, and Adolescent Health Network (RMNCAH) database, an association of nurses and other health workers in Bungoma County who majorly deal with community campaigns, focusing on the importance of ANC visits and ANC defaulters tracing, only 56% of pregnant women who attended their first ANC visit last year were able to complete the four required ANC visits in Bungoma County. The data further shows that 87% of pregnant women delivered by skilled health attendants. This means that 44% of pregnant women did not complete four ANC visits while 13% of pregnant women in Bungoma County did not deliver with the help of skilled birth attendants.

“Failure to attend the four focused ANC visits greatly contributes to maternal mortality. When a woman comes for her first ANC visit, we record her name, address, contact information and date of the next visit. We constantly check our records to identify the names of ANC defaulters,” says Grace Wanjala, the deputy nursing officer at Bungoma County Referral Hospital.

“We then contact them and advise them to come for their ANC visit. We also have records of the Community Health Volunteers (CHVs) in-charge of every village. In a case where the pregnant woman cannot be easily traced, we use the help of the CHVs. Sometimes we also hold campaigns to sensitize women on the importance of attending all the four ANC visits.”

Praxiors Wasibuye, a CHV at Namaya Village says that one CHV oversees 80 to 150 households. The CHVs identify, educate, and refer pregnant women for ANC in their area of service.

“We also do default tracing in our area of operation. Sometimes we are contacted and instructed to find out why a pregnant woman missed an ANC visit,” she adds.

Additionally, CHVs are trained to detect pregnancy danger signs, enabling them to know when a pregnant woman under their care needs medical attention. It is the task of a CHV and the pregnant woman to identify a motorcycle rider who can take      the pregnant woman to the hospital any time there is a complication. Payment is done through the RMNCAH network (which the County Government of Bungoma funds their network activities by about 40%, and the remaining funding comes from external donors. The association receives 4% of the total 30% funds allocated to health in the county) while all the medical care is taken care of under the Linda Mama Programme.

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