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January 22, 2019
When sex is too painful, or impossible
January 25, 2019

Maternal and newborn care must be equitable for all

Dear doctor,
I was traumatized by the recent unfortunate saga of dead newborns in Nairobi’s busiest maternity hospital. I live in the slums, am currently pregnant and unsure where to get better care?

What unfolded recently in Nairobi’s busiest maternity hospital is a tragedy. The whole scenario has replayed itself repeatedly in the minds of those of us who strive to provide quality care for women and their babies. The desperation of pregnant women waiting a whole day to be served is unacceptable. Eventually getting at the end of the queue, only to end up with a dead baby, is preposterous. And then the added trauma of undignified treatment of deceased newborns.

No Kenyan woman, regardless of their socio-economic status, deserves poor healthcare. Public facilities are mandated to provide acceptable standards of care. True, there are issues with healthcare funding, staffing, commodity supplies, and much more. But all this cannot be acceptable in the face of grand scale corruption that diverts public funds to enrich a few unscrupulous individuals.

Some women will feel so traumatized following this scandal, and may wish to seek care elsewhere. If caught in such a dilemma, you will need to look out for affordable care, most likely in a private facility. Beware that not all private facilities can provide quality care either. Look out for those with some sort of quality accreditation. Feel free to visit whichever facility you select, and get a feel of the standards they provide. Check how much it will cost too. The most expensive do not necessarily provide better care. What you are looking for is value, not unnecessary bloating of costs without linkage to better clinical outcomes.

You can use your mobile phone to register for affordable health insurance. A popular one is called M-Tiba, providing health insurance for as low as a hundred shillings monthly. Your insurance funds are maintained in a digital wallet, and are only accessible when you seek healthcare. You then get linked to accredited healthcare providers who have already been vetted for quality. This opens you up to accessing facilities which provide quality healthcare, and are continually improving their standards.

But the only way that majority of Kenyan women can get better healthcare is to improve quality in public health facilities. Let’s go back to the said maternity hospital. This sad event should trigger Nairobi County to conduct a clinical audit with immediate effect. Such an audit should have easy and quick deliverables, aiming to identify matters that require immediate attention to rectify the situation. There should then be medium to long-term action points, aimed at maintaining services to acceptable standards. There must then be an ongoing strive to maintain quality of care, which can easily be benchmarked with other public and private facilities.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist. amurage@mygyno.co.ke

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