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HEALTH-KENYA: A Glove To Save a Mother’s Life

KISUMU, Kenya, Sep 12 2009 (IPS) - The need for gloves for health workers assisting with childbirth may be obvious, but in Yala Sub-District Hospital in western Kenya, obvious does not mean available.

At the government-run health facility, serving about 96,000 people, there has been a shortage of gloves – and health personnel are overwhelmed.

“Are you going to send a mother away to buy gloves at night? We need to attend to her, but we cannot recycle gloves. At the same time we cannot touch blood,” said Eric Achira, nursing officer in charge of maternity at the facility.

People accompanying the woman are sent to buy gloves, but they often do not have enough money. Achira has on many occasions been forced to dig into his pocket to buy gloves and stock the maternity ward.

Kitale District Hospital, a higher facility and referral hospital, is nearly 180 km away. And it is also suffering a shortage of basic supplies such as gloves.

Staff shortages critical

Pregnant women are put at risk by more than a lack of essential supplies. The shortage of health personnel in government facilities also causes concern.

Ambira Sub-District Hospital, serving a population of 50,000 people, is typical: there are just two health officers who also work in the reproductive health unit.

"The staff shortage is critical. It is not possible to attend to a mother giving birth and at the same time check on other patients. There is a risk of delaying serious medical cases," remarked Okado Ochieng, a clinical officer who has been working more than 16 hours a day.

Ambira should have at least eight clinical officers to operate effectively, according to Ochieng. He spoke to IPS in late August, just after the minister for public health and sanitation, Beth Mugo, passed through the area campaigning for a by-election.

Mugo promised to increase the number of health personnel in Kisii if people voted her party in; she was sharply criticised for politicising healthcare.

Even though more health personnel have been employed recently, a wide gap still remains.

"We may have put in 4,000 health workers over the past three years – but the indication is we need about 15,000 within a similar period," Dr Josephine Kibaru, head of the family health department at the health ministry told IPS.

The overload is evident. At the time of this interview on Aug. 27, Dr Geoffrey Kasembeli from the Kitale District Hospital went on leave at the end of August: the first time since he began his practice in 1997.

“Supply of non-pharmaceuticals is an issue. We lack gloves from time to time, and this can be a challenge when it comes to providing a safe and clean delivery,” said Dr Geoffrey Wasembeli, obstetrician and gynaecologist at Kitale.

Women turn elsewhere

Where gloves are in short supply and women must buy them, some may be discouraged from seeking hospital deliveries, notes Monica Oguttu, executive director of the Kisumu Medical and Education Trust (KMET), a reproductive health organization working with communities in western Kenya.

As it stands, only about 41 percent of births in Kenya take place in hospitals under skilled birth attendants, according to government figures. A great percentage of births, particularly in the rural areas, are assisted only by traditional midwives who, besides not being able to deal with pregnancy complications, may lack equipment to perform clean deliveries.

“When health facilities are unable to provide basic supplies like gloves – and even syringes in some cases, we are simply telling women to seek services elsewhere. They end up with unskilled attendants, where they can die, adding to the already high maternal mortality,” Oguttu told IPS.

The national maternal mortality rate stands at 414 per 100,000 births, with parts of western Kenya such as Siaya battling rates of between 800 and 900 per 100,000, according to KMET.

Bring your own supplies

But efforts are under way to meet the need for basic medical supplies. For example, KMET has embarked on a pilot project distributing simple birth kits to pregnant women in Siaya, in western Kenya.

Popularly known as mama kits, each contains among other things a pair of gloves, cord clamp to tie the baby’s umbilical cord, sterilised razor, soap for hand washing and a polythene draper.

Women are advised to carry the kit from the eighth month of pregnancy, to avoid delays in looking for basic items when she checks into a health facility.

The kit is also handy in that some women may find themselves delivering at home, or on the way to hospital. The baby would then be delivered with safe equipment. About 2,000 kits have been distributed in Siaya, which has the highest maternal mortality rate due to infection, according to the latest government data available.

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