Marsabit celebrates improved universal healthcare access

It is almost five years since the Word Bank-supported Transforming Health System for Universal Care Project THS-UCP was initiated across Kenya, and Marsabit county is among the greatest beneficiaries.

The anniversary was marked by much pomp and celebrations, with the county now bragging about improved use of primary healthcare services from 37 percent to 71 percent.

Speaking at a ceremony to honour health centres at Jirmime Hotel, Governor Mohamud Ali recounted how THS-UCP helped shape and reinforce the county’s commitment to improving maternal, prenatal, and post-natal healthcare, among other targets.

“There is no doubt we have made significant gains in providing healthcare services. Three years back, access to maternal and prenatal healthcare stood at 31 percent against the current rate of 71 percent. That’s no mean feat for our county,” Governor Ali said.

“We’re glad that the THS-UCP has largely achieved the initial aim of improving utilization and quality and primary healthcare with a focus on maternal, reproductive, newborn child and adolescent health services.”

Through the programme and other interventions, the county has registered more fully immunised children and boosted expectant mothers attending antenatal facilities.

There is now also a fully equipped and functioning regional blood transfusion centre at Marsabit County Referral Hospital, 12 placenta pits (three per sub-county), and 50 portable HB machines for monitoring pregnant mothers’ hemoglobin levels have been procured.

The county Health department hired 400 community maternal and newborn care workers.

Some 750 community birth referral agents referring mothers to health facilities for skilled care by providing transport vouchers.

There are also integrated outreach services for hard-to-reach populations across the four sub-counties (48 sites) every month, including for vulnerable and marginalised communities.

Health executive Dr Jamma Wolde, for his part, said taking a closer look at the county’s report card in the health sector for the last five years reveals huge milestones made on several fronts.

He said the implementation of several measures to improve delivery outcomes such as THS-UCP, Beyond Zero Campaign, Big Four agenda, and free maternal delivery had helped reduce the maternal mortality and infant mortality rates in the region.

The measures strengthened the health system at county health facilities in urban and rural areas and improved the quality of services.

Governor Ali was impressed that the initiative on maternal deaths had improved access to quality maternal and neonatal healthcare services.

Before the initiative was adopted, Marsabit was cited as one of the counties with the highest maternal mortality rates, 1,127 per 100,000, and prenatal mortality of 60 per 100,000 live births.

The county’s mortality rates were over three times the national average (362) and the mortality rate for those under five years old was nearly twice the national average.

According to2014 Kenya Demographic and Health Survey, Marsabit was one of the 15 counties with poor maternal delivery outcomes, with the rate of stillbirths standing at 30.3 per 1,000 births.

Since the launch of the THS-UCP and Beyond Zero campaigns in the county, hospital access for mothers and ambulance services, especially in the remote villages, had greatly improved, thus averting more maternal and infant deaths.

Marsabit County Commissioner Paul Rotich also lauded the achievements made in county health services.

He also commended the county Health department for its efforts to improve universal healthcare services.

He said that finding sustainable solutions can help address preventable maternal and infant deaths.

“We also call for absolute behaviour change among our people in terms of security as without security and peace the county cannot have the optimal healthcare services,” Mr Rotich said.

Proximity to medical facilities has been a major challenge for the majority of rural pastoralist communities in Marsabit, with most expectant mothers losing their lives due to inadequate access to blood for transfusion.

Previously, the nearest blood bank was in Embu County, almost 350km away, and even when blood was received from Embu, it could only be stored for a few days.

In addition to Marsabit’s complex health and social challenges, cultural practices such as female gentile mutilation (FGM) had been blamed as contributing factors in the county’s high maternal mortality rates.

FGM is still the norm for most young women in this region and an enormous challenge for behavioural-change health interventions
Creating awareness about the adverse impact of FGM on young girls and women was one of the steps in promoting maternal health.

Human rights advocates also played critical roles in helping to increase access to information and influencing transformative change in maternal health services, including prenatal and postnatal care, where rural women are uninformed about their maternal human rights (MHRs).

Civil society organisations such as Saku Accountability Forum (SAF) have also been at the forefront in training paralegals and experts to reach over 5,000 women aged between 15 and 49 through household visits, community learning forums, and public outreach via broadcast and digital media.

Over 2,000 people have been reached directly and are more informed about MHRs through the project’s interventions.