Optimising women’s health in this city… and beyond

The promise of free maternity services by the Jubilee government has brought into the limelight issues about maternal health. Far too many women in Kenya die during pregnancy and labor.

The statistics are depressing, nearly 500 deaths in every 100,000 live births. And to make it even more depressing, majority of these deaths are avoidable even with our current resources!

So why do so many of our women die?Many factors are at play, boiling down to optimal care during pregnancy and skilled birth attendance. Our constitution affirms the right to health for every citizen, further underlined by Vision 2030’s Social Pillar that targets equitable and affordable health care for all Kenyans.Our statistics might be better in 2030, but we can’t wait till then, far too many women will have died in between.

A free service is a good starting point. But this has to be augmented by an enabling infrastructure. Facilities must be accessible, have the right equipment and in working order, and be manned by adequate numbers of health care workers with appropriate training.Majority of the women who die are in the lower socio-economic groups, living in locations with hardly any infrastructure. They are the farthest removed from decent health care facilities. And it’s no use not being able to reach a free facility, or eventually getting there only to find critical equipment and other supplies missing. Skilled staff presence is another matter, somebody must be available to deliver the service. And not just ordinary service, it must be the best care in the most humanistic way possible.Otherwise women willturn back rather than get humiliated in our facilities.

Women must take responsibility for their well-being too. Just over 40 percent of women attend the recommended antenatal care visits. Where are all the rest? There are issues about beliefs and other social barriers, leave alone access to facilities and associated costs. And some appear unable to make decisions in good time even when it’s obvious they need medical intervention. They present too late for their lives to be saved, no matter whether the services are free or not!And this is where education comes in. Our women must be aware of signs and symptoms that portend danger, and act appropriately. Advocacy by local opinion leaders can also play a role in addressing social barriers to seeking modern health care.

There is still more to do. We must find ways of retaining health care workers with incentives that will maintain their commitment to public service delivery. Women’s health services must all be integrated to provide holistic care that spans from family planning to infectious diseases like malaria, TB and HIV. Free maternity care in isolation is only part of a big equation. We must do more and stop our women from dying needlessly.