[A section of Kisii Teaching and referral Hospital in a past photo. A report released by the University of Indicates that emergency training reduces infant mortality. Photo/Nation]
A report released by the University of Nairobi and a local NGO has named lack of emergency training in health facilities as a major factor in infant mortality.
It also noted the lack of supplies and high staff turnover as contributing towards the death of infants during delivery and within the first 24 hours of birth.
The report funded by United States Agency for International Development, contained the findings of a study by the institution and the NGO on the effect of emergency training on reduction of infant mortality.
Dubbed "Partnership in Enhanced Engagement in Research" (PEER), the report on the project that took three years to complete recorded 258 deaths out of 13, 326 deliveries, representing a mortality rate of 1.9 percent.
Researchers focused on 13, 326 deliveries done within 16 state health facilities in the county by 90 staff trained in emergency procedures over a three year period.
The facilities targeted in the research were Iranda, Kiogoro, Iyabe, Marani, Matongo, Misesi, Nyagoto, Nyamagundo,Monianku, Eberege, Entanda, Kionyo, Magenche, Nyamache, Nyamasibi and Raganga.
It was prepared in conjunction with maternal health care NGO Program for Obstetric Simulation and Team-based training on Emergency and Neonatal Care (PRONTO), a maternal child healthcare NGO.
Addressing participants during a workshop in Kisii Town to debate the report’s findings, Kisii County Director of Medical Services Dr Geoffrey Otomu said emergency training for maternity staff had a positive impact on reduction of 24 hour infant mortality.
“There is need to ensure that medical personnel in the maternity child health sector are trained in emergency services in order to reduce cases of infant mortality. This will ensure that the cases of unnecessary deaths during and after the delivery of babies are eliminated,” said Dr Otomu.
Kisii County Director of Medical Services Dr Geoffrey Otomu said the uptake of free maternity services by pregnant women in the county now stood at 70 percent, up from a percentage of just 44 percent before devolution of health services.
“We have so far seen a 70 percent MCH uptake by pregnant women the program which is an indicator that the program is an overall success story,” said the medic.
He appealed to more women to attend clinic in government facilities, saying it was their best chance to ensure the survival of their babies.
“Expectant women will do themselves and their unborn babies a great favour by attending the free MCH services offered. It will go a long way in securing their children’s survival,” said Dr Otomu.
He said the county government had reached out to traditional birth attendants (TBAs) in a bid to stem the tide of infant deaths during and shortly after delivery.
“We have reached out to several TBAs in the county for education and despite initial suspicion on their part, most are now confident that their role has not been superseded by modern medical care,” said Dr Otomu.
The USAID-funded project’s lead researchers said the lack of training had hampered the efforts of medical staff to handle emergencies during and immediately after delivery.
Dr Onesmus Gachunu, senior lecturer in Obstetrics and Gynaecology at the University of Nairobi, said the researchers wanted to see whether enhanced emergency training for medical personnel would result in the reduction of infant mortality.
“Our findings have shown that emergency training for medical staff can considerably increase the survival chances of newborns. Through enhanced training in handling pre-delivery and post-delivery emergencies, we can reduce infant mortality by more than 50 percent,” said Dr Gachunu.
The medic said the report would be submitted to international medical journals for publication, adding that more research was required to analyze the impact of “Due to financial constraints and the limited time frame allocated to the project, we fell short of our target of 100, 000 births but we did observe significant improvements in child survival compared to the previous period before our staff were trained in emergency MCH services,” Dr Gachunu said.
He said other health workers in the county would benefit from the program since the trainees had also been empowered to train their colleagues.
“We also involved the beneficiaries in a mentorship component whereby they will also cascade the program to their colleagues. This way their colleagues will also improve their capacity to handle delivery-related emergencies,” said Dr Gachunu.
The national neonatal rate is 360 per every 100, 0000 births, with the maternal rate at 27 per every 100,000 births.
According to Dr Minnie Kibore, a researcher with Pronto, there was need for refresher training for maternity personnel so as to significantly reduce cases of 24 hour mortality.
She identified the lack of skills, newborn resuscitation equipment, commodity supplies, essential newborn care, emergency drugs and staff turnover as some of the major challenges hampering the delivery of quality maternal health care services in the region.
“We also noted that there was need for active management of third stage labour during delivery and proper care of the umbilical cord wounds after delivery as a safeguard against infant mortality that occurs after 24 hours,” said Dr Kibore.
She called on maternity staff to practice kind and sensitive care of their maternity clients as a way to ensure the success of the MCH system.
“Our best guarantee of infant survival is to avoid putting mothers under undue risk and pressure during the delivery period, and following the baby’s progress afterwards,” said Dr Kibore.