Strategy to end preventable newborn and child deaths
What you need to know:
- On average, newborn deaths in Kenya are 800 per month to asphyxia, prematurity complications and neonatal sepsis.
- Pneumonia remains the leading cause of death in children under five years.
Last year Kenya lost close to 10,000 children to preventable causes, with the country recording about 800 deaths per month, according to data extracted from the Kenya Health Information System
On average, newborn deaths in Kenya are 800 per month to asphyxia, prematurity complications and neonatal sepsis.
In the last year, Narok, Samburu, West Pokot, Marsabit and Mandera have recorded the highest neonatal deaths majorly caused by a high prevalence of pneumonia among children.
Pneumonia remains the leading cause of death in children under five years.
Highlighting some of the factors that have contributed to the high number of deaths in neonates, Dr Caroline Mwangi, the head of the Division of Neonatal and Child Health at the Ministry Of Health, said quality services to sick newborns in the country is wanting.
From the data, it is estimated that only 25 per cent of sick newborns are cared for in a facility able to provide a basic minimum package of services, with only 29 per cent providing a bed for caregivers taking care of low birth weight infants
“Even in facilities that are equipped to deal with neonatal health issues, bed occupancy is often above-recommended norms (with babies sharing incubators/cots), nurse-to- baby ratios are often very high (typically one nurse attending to over 15 sick babies and even higher ratios on night shifts) and much of the needed nursing care such as feeding, comforting and maintaining hygiene is not done because staff are overburdened and on occasion, work may be poorly organised,” says the data. Private hospitals capable of providing high-quality care are unaffordable to the vast majority of the population and low cost, small private facilities often provide care of poorer quality than the public sector.
Also, inaccessibility of facilities given the geographic area of a region, particularly in the Arid and Semi-Arid Lands regions, and lack of quality maternal and newborn health services has largely contributed to neonatal deaths, with the Kenya Harmonised Health Facility Assessment 2018 noting that out of 81 per cent of facilities in the country offering antenatal care services only four per cent of the facilities had all of the tracer items available.
Neonatal care
Half the facilities offered delivery services, but only 25 per cent of the hospitals could offer comprehensive emergency obstetric and neonatal care.
Dr Mwangi also pointed out that low financial resource allocation to interventions aimed at improving newborn and child health indicators was a bigger hindrance in reducing the numbers.
With the bad indicators, the Ministry of Health has developed Newborn and Child Health Strategic Plan (2021-2026) aimed at accelerating efforts to reduce newborn and child mortality and equitably promoting their health, development and well-being.
The document highlights the most critical indicators that will be used to measure the attainment of the strategic goal at the end of the five-year strategic period.
Dr Mwangi said the vision of the division is to have a Kenya where all newborns survive, thrive and live to their fullest potential.
“We are mandated to provide access to quality and comprehensive early childhood development interventions for children especially in the first 1,000 days of life,” she said, adding that for children to survive, the country invests in low-cost interventions including early essential newborn care, kangaroo mother care, and appropriate use of antibiotics for neonatal infection.
Other low-cost interventions to effectively improve pre-term survival include steroid injections to speed up the development of the baby’s lungs and rational use of antibiotics to treat neonatal sepsis.
On the thrive principle, the country will implement interventions that promote access to quality and comprehensive early childhood development interventions for all children especially in the first 1,000 days of life based on the Nurturing Care framework.
“As a country, the policies and guidelines have been developed at the national level and implementation is done at the county health facility level. Training guidelines are also utilised to ensure health care workers are trained with the latest updates in the management of sick newborns and children,” she says.
Ministry of Health Acting Director for Preventive and Promotive Health Services Andrew Mulwa said several measures are in place to reverse the trend.
“Neonatal mortality remains a key issue of public health concern in our country,” Dr Mulwa said, raising concern over an increased number of deaths of pre-term babies.
“Interventions are in place to ensure improvement of under-five health outcomes. We must reduce the number, by all means, this will start by ensuring that essential medicines are available in facilities and also strengthening community interventions to ensure early health-seeking behaviour’’
Head of the Department of Family Health at the ministry Issak Bashir urged communities to adopt simple proven solutions to end pre-term child deaths. This includes the kangaroo care programme that has been rolled out in about 40 counties.
“We need solutions that focus on high impact but low-cost interventions such as kangaroo care, which requires skin-to-skin contact between the mother and the newborn at no cost,” he said.
