By Mike Mwaniki
A shocking new report has revealed that doctors, clinical officers and other health workers caused nine out of 10 maternal deaths by providing sub-standard care to mothers who delivered in public health facilities in 2014. The first ever confidential report titled: “Saving Mothers Lives: Confidential Enquiry into Maternal Deaths in Kenya” says of the 484 maternal deaths assessed, 447 (92.4 per cent) did not receive the highest quality of care.
The young mothers who died and whose median age was 27 years, with the youngest aged 14 years while the oldest was 47 years succumbed to pregnancy and childbirth conditions such as severe bleeding, intrapartum and postpartum. Others died from non-obstetric complications mainly HIV/Aids and anemia. Delay in starting treatment (33 per cent), inadequate clinical skills (28 per cent) and inadequate monitoring (27 per cent) were the most frequently identified health workforce-related factors.
And in a bid to reverse the worrying trend, Health experts led by Director of Medical Services, Dr James Kioko, who launched the report, urged the health workers to immediately change their attitude to stop the unnecessary maternal deaths as Kenya embraces Universal Health Coverage (UHC). A majority of the deaths, seven out of 10 deaths, occurred during “peak-hour” between 5pm and 8am on weekdays, weekends and public holidays.
Majority of those who died from indirect causes were from Nyanza region 24 (25 per cent) and Nairobi 23 (24 per cent). Dr Kioko said all counties should immediately ensure their systems are reactivated after 5pm. “As we all embrace UHC, access to the highest quality of healthcare services should also be prioritised in all our public health facilities.” Dr Kioko urged all CECs of Health in the 47 counties to ensure that an audit of mothers who died in their jurisdictions was done immediately and action taken against those found culpable.
“(It is noteworthy) that 91 per cent of women who died of obstetric bleeding received sub-optimal care, where different management would have resulted in a different outcome… “Most women were managed in level 4, 5 and 6 facilities and expected specialised care yet obstetricians were involved in the care of only 55 (11.4 per cent) of cases,” the report indicates.
At the same time, obstetricians were involved in the emergency care of only one in 10 women who died. Half (50 per cent) of all maternal deaths were among women who had been referred from another facility mostly from level 4 to level 5 or 6 health facilities,” the report says. The deaths occurred despite accelerated efforts by the government to minimise maternal and childbirth deaths through increased funding and other interventions.
President Uhuru Kenyatta has identified UHC as among part of his Big Four Agenda during his second term which include affordable healthcare, food security, affordable housing and manufacturing. Indeed, within six months after he was elected, the head of State, his government introduced free maternity services in public health facilities which have resulted in about 1 million women now delivering in the institutions.
