Fewer mothers are dying during childbirth in hospital in Bungoma after the county took simple actions like expanding blood supply to more health facilities, strengthening the referral process and mentoring health workers to handle pregnancy-related complications.

Figures from the Kenya Health Information System show that maternal deaths in the county declined by about a quarter in 2018 compared to 2014, the year before the rollout of the interventions.
Sobetter Musumba, 23, is one of the beneficiaries of the improved services.

A year ago, after completing her antenatal visits and having had an uneventful pregnancy, Sobetter looked forward to giving birth to her first child. When she went into labour at home, her husband immediately called a boda-boda to take them to the nearby health centre.

The trip cost them nothing because the Maternal and Newborn Improvement (MANI) project runs a programme where women who use boda-bodas to go deliver in hospital are reimbursed. The initiative is part of the Maternal and Perinatal Death Surveillance and Response (MPDSR) process that aims to expand access to quality healthcare in Kenya.

Bleeding profusely

But after waiting for six hours at the health centre without being attended to even as the labour pains became more intense, the couple gave up, opting to go to Webuye County Hospital.
On arrival, Sobetter was quickly attended to, and soon after, delivered a baby boy. But her joy was short-lived when she started bleeding profusely. She ended up undergoing two surgeries and a blood transfusion. She later learnt that she lost over 40 percent of her total blood volume.

Post-partum haemorrhage − excessive bleeding at birth − is the leading cause of maternal deaths.

Had Sobetter experienced the same complication at the hospital three years earlier, the outcome might have been quite different as the hospital suffered perennial shortages of blood.

Webuye County Hospital Nursing Officer in Charge Bramwel Musambaki recalls the challenges staff would face treating new mothers who developed severe bleeding during delivery. The hospital routinely did not have blood on standby and often had to call surrounding facilities, looking for units whenever the need arose. He remembers losing a patient who developed severe bleeding after childbirth because of inadequate blood supply just before the hospital started participating in the MANI project that also assisted the facility to set up a functioning blood bank and efficient record keeping.

Much of the blood is transfused to children who have developed anaemia from malaria and those with sickle cell anaemia.

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