Time for health workers to voice out women’s health issues

Last week the country’s top technical people with regard to reproductive health gathered in Mombasa for a week-long congress to evaluate where we are as a country so far. The 47th annual Kenya Obstetrical and Gynaecological Society scientific congress took off on February 15, having been preceded by two days of skills training and learning for the specialists. 

With the recently launched Kenya Demographic Health Survey painting a mixed picture of the nation’s health, it was rather timely that the obstetricians and gynaecologists would take the time to showcase the advances, or as more aptly out, the disruptions in technology that provide solutions to some of the challenges that the country is facing. The event was graced by the International Federation of Obstetricians and Gynaecologists, just to show how serious this was. 

Despite great strides being documented in certain aspects of the survey, a few important ones are still lagging behind remarkably, a situation that needs an urgent remedy. Drawing comparison from the previous survey that was launched a decade ago, areas such as neonatal mortality, child nutrition, adolescent reproductive health and HIV and Aids transmission do require a closer look.

The majority of these struggling areas have already been bundled together under the Primary Health Care; Reproductive, Maternal, Neonatal, Child, and Adolescent Health; and Nutrition (PHC-RMNCAH+H) programme. This literally completes the cycle of life as a continuum from the expectant mother, to the child she will bear through the various phases of childhood and eventually to be a mother herself, as supported by good nutrition, male involvement and ultimately, affordable and accessible care through primary healthcare. 

What was remarkable in this particular congress in comparison with the previous years was the heightened increase in interest in health policies that speak to PHC, RMNCAH and Nutrition. The congress showcased a large number of presentations that focused on the implementation of existing government policies to tackle sexual and reproductive health challenges that continue to plague our population. 

This was cross-cutting, from prevention of maternal mortality from postpartum haemorrhage; to prevention of pre term birth; to infection prevention in the workplace; to health commodities supply chain; to the prevention of cervical cancer by increasing uptake of the Human Papillomavirus vaccine, screening and treatment of precancerous lesions and early diagnosis and treatment of the condition; and to relooking prevention of HIV transmission and the upcoming novel technologies that aim to provide solutions. 

Prevent death

It is amazing to watch the transformation of the obstetricians and gynaecologists, who have spent their lives buried in their work striving to bring forth life and prevent death, wake up to the realisation that they remain the primary advocates for their patients. The many years spent in extensive research and the heavy contribution to development of national policies mean nothing if we all don’t join hands and advocate for implementation of these policies. 

Health policy implementation translates to equitable, effective, acceptable, and economically feasible delivery of care to the population at large. Policy development factors in review of available up-to-date evidence to guide decision-making, hence the postulated solutions to a problem have been well thought-out and their implementation should be prioritised. 

Why then, pray tell, do we have a challenge with seeing the implementation through? For years, we have assumed that it is common sense to all that healthcare is sacred and should automatically be a priority for all governments, whether national or county. As the persons tasked with delivery of these services on the ground, the ultimate implementers of these policies, we have taken it for granted that everyone else knows that we need investment in the sector to enable us do our job.

In a country with a struggling economy right now and massively completing interests in service delivery, healthcare workers must come alive to the fact that health is just one of the cogs in this wheel. 

For it to garner attention, we must intentionally position health at the fore by continuously engaging with our leadership to ensure it does not fall through the cracks. Most of these health programmes have stayed alive due to donor funding. With our current positioning as a lower middle-income country, donors are steadily streaming out and we must dig deeper into our own pockets to make things work. 

To enable us to do this better, we must come together as professional associations, the wearers of the shoe, who know where it pinches most, and endeavour to highlight why it is important for our decision makers to put in money to support healthcare. This cannot be a one-person job. This is journey that requires that we all pull together to keep this agenda at the fore. 

This is the goal of the CEBA project, Championing Evidence-Based advocacy for PHC-RMNCAH+N; a project that is working to ensure that as a country, we benefit from the technical support of our professionals while working together with like-minded persons to advocate for increased allocation of resources for health.  This year, the Kenya Gynaecological Society has joined hands together with the Kenya Medical Association, the Kenya Paediatric Association, the National Nurses Association of Kenya, the Kenya Clinical Officers Association and the Nutrition Association of Kenya under the umbrella of the Kenya Paediatric Research Consortium to amplify our voices with regard to preserving the cycle of life.

It is definitely not going to be business as usual!

Dr Bosire is an obstetrician/gynaecologist