Making childbirth safer in Kenya with on-the-job training
Irene Chemitei, now a proud mother of four, safely delivered her child, Ivy, in April at the Emining Health Centre in Baringo County, Kenya. After arriving at the hospital, Irene was admitted to the modest eight-bed maternity wing, and Vivian Cheptoo, the night nurse, helped Irene deliver Ivy a few hours later.
Vivian and seven other nurses managing the maternity wing can handle routine deliveries and most complications during pregnancy and childbirth. They refer only the most serious cases to the main subcounty hospital in Eldama Ravine, which is about 40 kilometers away.
To ensure that health center workers are trained to handle most complications of pregnancy and delivery, FHI 360’s Afya Uzazi project works with the Ministry of Health and county governments to continuously improve the quality of maternal and child health services offered in more than 180 hospitals, health centers and dispensaries across Nakuru and Baringo counties. The project provides training, supportive supervision and mentorship, as well as equipment and help with using data for decision-making. Since January 2017, FHI 360 has trained more than 190 health workers in basic emergency care for mothers and newborns, family planning and other areas.
Gladys Kipkulei, a colleague of Vivian’s at the Emining Health Centre, attended a week-long Afya Uzazi training on emergency care for pregnant women, new mothers and infants. She later briefed Vivian and other staff at the center on what she learned. “The training has benefited other staff through feedback and on-the-job training,” says Daniel Bundotich, the clinical officer in charge of Emining Health Centre. “I wish everyone would be trained.”
Sarah Kimaru, another nurse at the center, received training from Gladys and stated, “She [Gladys] came back and gave us an update on new practices and provides us with on-the-job training.” Sarah specifically talked about learning to manage high blood pressure during pregnancy and to care for newborns, particularly delayed clamping of the umbilical cord for the baby’s benefit.
“The services are very good here, and the health workers are ready to assist,” says Irene, who has delivered three of her four children at the facility and attended three antenatal clinics during her last pregnancy.
Despite improved services at Kenya’s health facilities, many women still deliver at home. Only half of pregnant women in Baringo County attend the recommended four antenatal clinic visits, and one in two children is delivered without the assistance of a trained birth attendant.
Afya Uzazi is building on the achievements of health facilities like the Emining Health Centre to further improve services and create a demand for them in local communities. The project and local health teams are conducting assessments to identify gaps in service delivery and develop cost-effective ways to address them. In the future, the Afya Uzazi team plans to engage the community through social and behavior change activities that will address barriers that hinder access to health services, including antenatal and postnatal care, hospital delivery and family planning.
Photo caption: Irene Chemitei in the maternity ward with her newborn baby at the Emining Health Centre.
Photo credit: George Obanyi/FHI 360