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Monday, April 24, 2017
Ms Mette Knudsen is Denmark’s Ambassador to Kenya. Follow her on twitter: @metknu. Siddharth Chatterjee is the United Nations Population Fund (UNFPA) Representative to Kenya. Follow him on twitter: @sidchat1
- On Friday, 06 November 2015, we had the honor of meeting the First Lady of Kenya Ms Margaret Kenyatta, a tireless advocate for “every woman and every child”, during the launch of the Beyond Zero campaign in Mandera County, North-Eastern Kenya, a place which has often been described as ‘the worst place on earth to give birth’.
Mandera’s maternal mortality ratio stands at 3 795 deaths per 100 000 live births, almost double that of wartime Sierra Leone at 2 000 deaths per 100 000 live births.
Two out of every three cases of maternal deaths occur in areas affected by a humanitarian crisis or in volatile onditions, such as the North-Eastern region of Kenya where increasing focus is being put on giving pregnant mothers a real chance of surviving childbirth.
Some 6 out of every ten maternal deaths occur in this region. Poor education, little use of contraceptives, traditions such as marriage, that tend to derail women’s self-determination, together with inadequate health services have kept led to these very poor health indicators.
What we realized was that almost every child born in the region is really a throw of the dice, a hit-or-miss proposition that local communities face with stoicism, but a situation that development agencies are increasingly determined not accept.
For just over a year now, UNFPA has worked with the H4+ partners (UNICEF, WHO, World Bank, UN Women and UNAIDS), to find ways not only to save lives at childbirth but also to meet related challenges of reproductive health in the six counties of Kenya that have the most maternal deaths.
The government of Denmark supports UNFPA’s programmes globally and in Kenya this support is based on a Denmark-Kenya Country Programme 2016-2020 that seeks to give momentum to Kenya’s Vision 2030.
The policy’s thematic programme on health specifically identifies operational support for primary health care facilities at county and national government levels as well as support for sexual and reproductive health and rights.
The Danish government is committed to supporting UNFPA to further ongoing work in Mandera, Marsabit, Wajir, Isiolo, Lamu and Migori counties to deliver a comprehensive package of services in reproductive, maternal, newborn, child and adolescent health.
Denmark has pledged US$ 6 million to help the six counties give greater focus to adolescent girls and young women, through targeted and evidence-based interventions in multiple sectors. Of key concern will be addressing drivers for early sexual activity among adolescent girls and boys, early childbearing and early marriage, and advocating for keeping girls in schools.
In a demonstration of how collaboration in development work can be done effectively, various private sectors partners have joined these efforts in the six counties, that are already showing positive results.
There is reason for optimism that we can expand the supply of quality services; that we can innovate for delivering cost effective interventions for family planning, emergency obstetric care, postnatal and newborn care.
Though it is the right thing to do, this partnership is not driven by morality but concrete evidence that reducing maternal and newborn deaths is the smartest investment for changing the fortunes of poor economies.
Our observations show that complex operations are not required to make a real difference; simple interventions such as ensuring more women give birth through a skilled attendant greatly increase chances of survival for mother and baby.
It is about convincing communities to eschew practices such as early marriage and others that invariably occur without girls’ consent, robbing them of their childhood, forcing them out of school, trapping them in poverty, and putting them at a higher risk of potentially dangerous pregnancies and childbirth.
It is about empowering women to plan whether and when to have children, thereby giving them a better chance to complete their education, increase their earning power and reducing poverty.
It is also about exploiting local resources, working with structures that local communities are comfortable with. In Wajir County for instance, local community health volunteers have been trained to identify pregnant women within clusters of some 10 000 people, linking them to local health facilities to receive antenatal care.
The volunteers provide health education to pregnant mothers on the importance of antenatal care, the importance of recognizing danger signs during pregnancy, during delivery and in post-delivery.
Already, deliveries under skilled care are increasing, assisted also the Kenyan government’s free maternity care scheme.
Global data indicates that the highest benefits from reducing unintended pregnancies would be seen in the poorest countries, with GDP increases ranging from one to eight percent by 2035. There are few interventions that would result in such wide-ranging impacts.
Sure as we are about the steps needed to move forward, it is, however a window that will not remain open forever and the urgency of the moment cannot be over-emphasized.