In Kenya, these interventions are decreasing maternal mortality

The In 2005 when Kenyan authorities first told Jane Bett to stop assisting women with home births, the traditional birth assistant had mixed feelings. Helping deliver babies was her passion –something she had volunteered to do despite being a farmer primarily –but she had also seen tragedies happen when things went wrong. “I saw a lot of women dying in my village. Women would lose a lot of blood, or their wounds were not tied up properly,” said Bett. “Sometimes you would try to help a mother but her placenta would refuse to come out and all you could do was pray. It was so dangerous.” In 19 years, she helped deliver 40 babies in Koiban, her village in Kenya’s Nandi County – home to an estimated 886,000 people. Almost a fifth of women across 11 countries in East Africa still prefer home delivery, according to a 2022 report by Ethiopian researchers. These births, usually with the help of traditional birth attendants and no health care professional present are mostly done under unsanitary conditions leading to high maternal mortality rates in the past. In the last decade, hundreds of former midwives, so often evangelists of home births, have transitioned to educating expectant mothers on the importance of giving birth in proper healthcare facilities. In 2013, Bett became one of them. These days, she even accompanies pregnant women in labour as they race to get to the hospital in time, on motorcycles. The transition is being facilitated by Kenya’s Community Health Strategy. In 2000, the Kenyan government launched the programme to improve public health by training trusted local community leaders to become community health volunteers. It was initially piloted in a few counties before eventually spreading nationwide. Volunteers spend about two hours per day educating their peers about primary healthcare. Many do this for free but sometimes they get stipends of up to 8,000 Kenyan shillings or $66 per month. In Nandi County, that strategy seems to be working fine. The percentage of women giving birth in the presence of a skilled birth attendant has almost doubled, from 37 percent in 2017 to 69.5 percent in 2021, according to the Kenya Health Information System (KHIS). That is slightly better than the national average, which was 65.3 percent as of June 2021, according to KHIS. — Aljazeera