Population Council Projects | Changing the Face of Maternal and Newborn Health in Kenya

PROJECT
Changing the Face of Maternal and Newborn Health in Kenya

The Safe Motherhood Demonstration Project (2000–03) aimed to contribute to the reduction of high maternal mortality and morbidity in Kenya by addressing the “three delays” in receiving skilled attendance: (1) deciding to seek care; (2) identifying and reaching the health facility; and (3) receiving adequate and appropriate treatment. Population Council staff members in Nairobi worked with staff from the Division of Reproductive Health, Ministry of Health, and the University of Nairobi to devise a new approach to maternal and newborn health (MNH). The approach, introduced in four districts in Western Province, focused on addressing resource and skills gaps in service provision as well as working with communities to improve access to and increase utilization of high-quality maternal and newborn health care services. Specific interventions involved providing competency-based training tailored to staff needs, ensuring that basic equipment, supplies, and drugs were available, and working toward greater community involvement in demanding high-quality services. These interventions contributed to improvements in MNH services in the four districts.

Building on the lessons learned, Council staff members assisted districts in improving their health systems using maternal and newborn health as the entry point. Council researchers developed and piloted a simple rapid appraisal tool to assess the MNH situation in facilities as well as a district implementation framework for improving MNH programs.

In addition to addressing skills and service-delivery issues, Council staff members piloted innovative solutions to the low skilled attendance rate by developing a community midwifery model, birth preparedness cards, and prepayment schemes. They also piloted and scaled up nationally the use of magnesium sulphate for managing severe pre-eclampsia/eclampsia. In addition, because staff members identified a gap in the care that mothers and babies receive after birth, they sought to reposition postpartum care so that it receives the same emphasis as antenatal care. The resulting targeted postpartum care model includes three comprehensive assessments of the mother and baby from birth to six weeks postpartum.

To increase awareness of MNH issues Council staff members worked with award-winning journalist Brigid McConville and her colleague Dr. Gwyneth Lewis, advisor to WHO, to develop the acclaimed film “My Sister, My Self” that was shown at the May 2003 World Health Assembly in Geneva. McConville and Lewis also directed a subsequent film, “Beyond the Numbers,” which was shown at the 2004 World Health Assembly. Partly based on their experiences working with the Population Council in Kenya, in June 2005 McConville and Lewis launched a new charity, The BirthDay Trust, to encourage safer pregnancy and safer childbirth for mothers and babies around the world.

Building on the footage shot in Kenya, Council staff in Kenya identified and commissioned Kenyan musician Eric Wainaina to write a song about motherhood in which he praises mothers for bringing new life into the world. The song is becoming popular in Kenya.

Because of their tremendous involvement and effort in addressing MNH issues, Population Council staff members in Kenya are key members of the National Reproductive Health Committee and a number of national working groups on MNH. Staff members Charlotte Warren, Wilson Liambila, and Anne Mwangi are widely recognized throughout Kenya and the sub-Saharan Africa region as experts on maternal and newborn health.

Location

Western Province, Kenya

Duration

2000–03

Population Council researchers

Charlotte Warren, Wilson Liambila, Anne Mwangi

Non-Council collaborators

University of Nairobi, Department of Obstetrics and Gynaecology, Department of Community Health

Government of Kenya, Ministry of Health, Division of Reproductive Health

Donors

UK Department for International Development

Publications/Resources on this project