Maternal Continuum of Care

Maternal Continuum of Care

Need

 

Despite some progress made by the Millenium Goals,

Kenya's maternal mortality rate of 510 deaths per 100,000 live births remains among the highest in the world.

Kenya is considered one of the most dangerous places in the world to be pregnant.

 

The cause is multifactorial 

 

- Barriers to access

     The distance to a hospital is far & cost of travel is prohibitive

- Low use of prenatal care services

      Only 50% of women attend even one prenatal care visit

- High rates of home deliveries

      In rural areas, up to 83% of deliveries are at home

- Female genital mutilation (FGM) has an impact on maternal & neonatal health outcomes. FGM causes vaginal wall scarring and abnormalities that alter the birth canal. This results in babies dying from asphyxia due to obstructions at the vaginal wall. Unfortunately, most local providers are not properly trained in managing this complication.

Response

In collaboration with the West Pokot Ministry of Health we developed a Maternal Continuum of Care program designed to promote facility based prenatal care-seeking and increase the number of hospital deliveries. We recently incorporated family planning into our continuum, offering free post partum IUD placement for women who deliver at the hospital.

 

 

Provider training is an essential element of our program. Our medical team travels to Kenya 2-3 times per year for pro bono surgical missions to correct birth-related complications such as fistula and incontinence, and we capitalize on this opportunity to train local providers on clinical protocols and surgical procedures, including those required to facilitate deliveries for patients with female genital mutilation (FGM). Another critical aspect of this collaboration involves piloting a low-tech preterm birth indicator in this population. We are very excited about this study, as the ability to predict preterm birth would enable providers to triage at-risk patients and ensure that they receive appropriate care: care which is essential to survival of the newborn.

And we have gotten results

Our Maternal Continuum of Care Program was launched in West Pokot in early 2015 and since then:

%
increase in prenatal care
%
increase in hospital deliveries
%
decrease in neonatal mortality

Our work in action

Photographer Lori Hawkins documented her experiences in West Pokot

 

 

 

MamaNatalie is used at a Saving Mothers training session for Traditional Birth Attendants (TBA) in Kapenguria on March 7, 2018. As part of this training, Dr. Tara Shirazian and Dr. Noel Strong taught the birth attendants skills to cope with obstetric emergencies and led an open discussion on issues the TBAs face in their daily work in the field. Saving Mothers visited West Pokot, Kenya and screened over 300 women and provided many types of surgery include molar pregnancy, ectopic pregnancy, hysterectomy, prolapse and fistula.
Saving Mothers visited the Keringet Health Center in Keringet, Kenya on March 8, 2018. Saving Mothers visited West Pokot, Kenya and screened over 300 women and provided many types of surgery include molar pregnancy, ectopic pregnancy, hysterectomy, prolapse and fistula.
Saving Mothers fellow, Leah Jones, Antonet Kpar, and Dr. Tara Shirazian review the steps to insert an IUD on March 9, 2018 in Kapenguria, Kenya. Saving Mothers visited West Pokot, Kenya and screened over 300 women and provided many types of surgery include molar pregnancy, ectopic pregnancy, hysterectomy, prolapse and fistula.