How Kenya can save more of her preterm babies

This year’s World Premature Day was marked November 17 under the theme, “Born Too Soon: Providing the right care, at the right time, in the right place.”

The day acknowledges the journey of preterm infants and their families and raises awareness of the challenges faced by them.

Preterms are babies born before 37 weeks and as such require monitoring in the new born unit (NBU). This is routinely done by neonatologists and neonatal nurses.

According to Unicef, approximately 15 million babies are born preterm across the globe every year. In Kenya, the figure stands at 188,000. At Moi Teaching and Referral Hospital (MTRH) at least 600 babies are delivered preterm in a year.

Reports attributed to Kenyatta National Hospital (KNH) indicate that 50 per cent of all deliveries comprise of preterm babies. Preterm birth complications are the leading cause of death among children under five years.

Saving preterm babies requires concerted efforts, including investing more in new born units across the country, training of neonatologists and neonatal nurses.

Currently, such trainings are undertaken outside the country. The University of Nairobi and Moi University College of Health Sciences should consider training around this medical discipline as part of their contribution towards universal health coverage (UHC).

A few years ago, hospitals in the country would lose almost 80 per cent of the newborns who were below 1,000g, but this is being reversed courtesy of interventions by the Ministry of Health.

For instance, in western Kenya — a catchment area served by MTRH — we are now able to save almost 70 percent of the newborns who are below 1,000g and more than 80 percent of those above 1,000g.

This has been made possible through investments in human resources for health (HRH), modern medical equipment, proper laboratory work, high quality original drugs, establishment of neonatal intensive care unit (NICU), investments in paediatric theatres and working closely with county hospitals to ensure safe transfer of neonates to MTRH through referral mechanisms.

It is also encouraging to see corporates such as Safaricom Foundation coming on board to support us in this initiative.

As part of activities leading up to World Premature Day, the foundation donated newly procured medical equipment, including incubators, infant ventilators, cardiac monitors and phototherapy machines worth Sh10 million, to our NBU.

Such partnerships support the healthcare system in the country to further improve on the quality of specialised healthcare of newborns.

We are calling upon more private and public sector players to consider partnering with the public health sector, through the Ministry of Health, so we can establish more NBU and NICU facilities to cater to preterm babies considering that they are such a delicate lot that cannot transition to a normal living environment unlike the normal babies delivered at full term.

Currently, the NBU at MTRH with a bed capacity of 50 and bed average occupancy of 180 preterm babies, serves western Kenya region, parts of Eastern Uganda and Southern Sudan. KNH also experiences the same challenges.

There is need for more of such facilities in the country coupled with training of HRH. This will be one of the ways of accelerating realisation of UHC.

To address some of these challenges, other concepts like Kangaroo Mother Care (KMC) have also taken root in western Kenya and other parts of the country.

Proponents of this concept contend that it prevents hypothermia (dangerously low body temperature), has low-risk for infection, and high survival rate for the preterm, with partners (in this case the father of the child) expected to help their wives in caring for the preterm.

This notwithstanding we need to improve the quality of antenatal care in both our public and private facilities to reduce the risk of stillbirths and pregnancy complications and give women a positive pregnancy experience.

By focusing on a positive pregnancy experience, we not only ensure a healthy pregnancy for mother and baby, but also an effective transition to labour and childbirth.

In a bid to improve maternal healthcare, the government, through the National Hospital Insurance Fund (NHIF), introduced the Linda Mama programme, a package of health services accessed by women on the basis of need and not ability to pay.

This was aimed at encouraging women to deliver in public and faith-based hospitals so as to reduce pregnancy-related morbidity and mortality in the country.

It has resulted in increased numbers in our facilities and reduced infant mortality.

However, more investments need to be made by county governments in maternity and neonatal services as well as in health promotion and education to complement the efforts of the national referral facilities towards attainment of UHC.

One of the resolutions that came out of the International Conference on Population and Development (ICPD) held in Nairobi recently was the commitment to zero maternal mortality.

Let us all ensure that no mother dies while giving life since every child has a right to live.

Dr Aruasa is the chief executive of Moi Teaching and Referral Hospital(MTRH).