January 19, 2014
The Jubilee alliance’s promised ‘free’ maternal healthcare package for Kenya is presently coming at the cost of malpractice and inefficiency. Can a better service be delivered?
Maternal healthcare in Kenya is now free of charge as promised by the Jubilee Alliance during their pre-election campaign but the situation seems to be doing more harm than good to mothers judging by the recent cases of deaths witnessed in maternity wards.
Experts in health matters had expressed their concerns over the free maternity offer by Uhuru Kenyatta’s government citing that public hospitals are understaffed and ill-equipped and will be incapacitated to handle the influx of expectant mothers flocking in for free deliveries.
Negligence by nurses has been the biggest nightmare patients seeking medical aid in public hospitals have to contend with and a good number of patients have died on waiting lines in public health facilities as their relatives watch helplessly.
Expectant mothers have had it rough whereby in facilities such as Pumwani Maternity Hospital and even at Kenyatta National Hospital they are forced to share beds. Some are not lucky enough to get a bed of any sort, having to be content with the floor as they wait their turn on the delivery bed.
Dealing with rude, mean and insensitive nurses has also been another challenge expectant mothers’ face in publicPumwani Hospital hospitals and these reasons explain why home births are so common in the country, especially for women who cannot afford to go to private hospitals. According to recent statistics, more than half of the about 1.5 million (56 per cent) women who give birth annually in Kenya give birth at home.
A report compiled by the Kenya National Commission on Human Rights in 2012, following a Public Inquiry into Violations of Sexual and Reproductive Health Rights in Kenya, established that there is widespread medical negligence and malpractice in health institutions.
Most cases of medical negligence and malpractice reported were obstetric cases that suffered various types of injury and suffering to mothers and their babies. Long waiting periods and delays in getting attended to in health facilities were also common. Negligence in the management of labour can actually result in stillbirth, giving birth to a mentally/physically handicapped child and maternal death.
Yesterday, a woman lost her baby while delivering at the Nyeri Provisional Hospital after the baby came to birth and fell on the floor head first. According to 27 year old Charity Wanjiku, the nurses had ignored her all through her labour.
The Nyeri Hospital Medical Superintendent Cyrus Njoroge however attributed the death to a shortage of nurses, alleging that the hospital currently has only 250 nurses when it actually requires 600.
Five months ago, four babies died at the Kiambu District hospital allegedly after there was a power blackout. The babies had been born pre-term and were in incubators.
A good number of children and other patients have also died in public hospitals following the rampant strikes by health workers that have hit the country. A seven months year old infant died mid December last year at the gates of Coast Provincial General Hospital due to lack of medical attention following a doctors strike.
Child and Maternal mortality still remains a big concern as far as maternal healthcare in Kenya goes. Under the Millennium Development Goals for Health, the government aims to reduce by three quarters (75%) between 1990 and 2015, the maternal mortality ratio which currently stands at 488 per 100,000 live births, according to the last Demographic Health Survey of 2008/2009.
Also in the same line, the governments aims to reduce the Infant Mortality Rate (IMR) and the Under Five Mortality Rate which currently stands at 52 per 1000 live births and 74 per 1000 live births respectively, to infant mortality (26/1000) and under-five mortality (33/1000) by 2015.
However health experts keep warning that focus on child survival will still be a challenge unless neonatal care, which is closely linked to maternal care, receives more attention.
If the government is to succeed in giving decent healthcare to Kenyans then more needs to be done like hiring and training of more medical practitioners especially obestricians, midwives and nurses. A massive investment to expand health infrastructure should also be undertaken as well. In addition, the government should increase the funding allocated to the health sector especially with the introduction of free maternity because most hospitals used to recover operational costs from at least one fifth of the revenues from maternity charges.
Cases of negligence should also be thoroughly handled by the respective health bodies and culprits found guilty subjected to the necessary disciplinary actions.
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