VOICES: The perspectives of Kenyan Mothers

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MAISHA March 2015

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Within project work it is always important to refer back to the goal guiding MAISHA: to improve maternal and newborn health. To keep this as a constant focus it is helpful to visit mothers in their homes and at facilities to better understand what challenges they face and how the MAISHA project has impacted their lives. In the last two weeks of February, in conjunction with the visit of a Canadian journalist reporting on maternal health projects in East Africa, the MAISHA team traveled throughout the catchment areas in Migori and Nyeri gathering critical qualitative data. This dispatch aims to recount some of the stories of Kenyan mothers and to give rise to their voices and lives.

When Miracles Occur

The mother in the top photo is holding her son outside their home (top left) in a rural area near the Tanzanian border and is about a 7 km walk through cornfields, grazing lands and small shambas (farms) to the Nyamaraga health facility. While the beautiful smile and health of

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both mother and baby is something we often take for granted, things could have been very different for these two.

Just five days before this picture was taken Mary* was walking to her final ANC visit when she actually gave birth alone in the bushes. She was able to call her husband after delivering, who arrived on motorbike to assist her. Miraculously the baby was alive and they cut the umbilical cord with a sharp piece of sugar cane. However, Mary had lost a lot of blood, her uterus had inverted from pushing, and the placenta wouldn’t release leaving her in severe pain and at high risk. She arrived at the Nyamaraga clinic where EmOC trained nurses treated her before she was transferred to the county hospital – about an hour’s drive away!

Whilst Mary’s story is both heroic and harrowing it is a critical reminder that women face a multitude of challenges to their maternal health. Giving birth shouldn’t put women at risk of losing their lives. For this reason MAISHA

Calendar

March 2015: MAISHA enters Year Four

April 2015: Midterm Review in Migori and Nyeri

June 2015: COTR Nursing Students Exchange

Onwards: Technical training modules for CUs

works to improve the capacity of both health workers and volunteers and the communities they serve.

The Role of the Community

The commitment of health workers and community units brings into focus the daily challenges mothers and families face in rural Kenya. The key issues remain transportation and distance to health facilities, insufficient resources, conflicting information, myths or traditional belief systems and an accessible source to potable water and sanitation.

As Mary’s story illustrates accessibility to health facilities is still a major obstacle. The path that Mary takes to Nyamaraga is not entirely passable by a motorcycle – if indeed a family can afford to hire one for medical visits. Even so, Mary was willing to make this trek since she had been informed by a CHV during a home visit and at previous ANC visits that it is safer to deliver in a facility than at home. Home deliveries by traditional birth attendants (TBAs) continue to occur. However, the role of CHVs has begun to change this. As Peter, a Public Health Officer in Nyamaraga, points out, “If you empower the community members they will come to health facilities with informed choice.” He goes on to state, “we need to start at the community level where attitudes are formed.”

+ “I would advise other expectant mothers to deliver in a hospital because the nurses are trained and know a woman’s needs and problems.” – Leah, Kamoko area

Meet baby Ibrahim, age 6 weeks. On the day of our visit his mother, Leah, had brought Ibrahim for his first post-natal visit, which includes his first set of vaccinations, including polio. Ibrahim was born at the MAISHA supported Kamoko Health Facility by a nurse trained in

Empowering Women

Leah, the mother in the top photo holding baby Ibrahim, proves the new model of motherhood in Kenya. While Leah herself was delivered at home, along with her 5 siblings, she is firm that delivering at a health facility is preferred. Leah chose to deliver at her local health facility because she said she was treated well by the staff, received her ANC there, and was provided warm water for washing and food post delivery. Leah believes free clinic services are an incentive for more women to deliver in a facility rather than at home with the help of a TBA. In addition, from the family planning education she received at the clinic, Leah has decided she only wants two children.

Family planning options continue to be a contentious issue in rural Kenya, where misinformation and traditional beliefs often result in large families – even if mothers would prefer otherwise. CHVs and health workers help to change these attitudes by sharing appropriate information and options to community members. Similarly, traditional gender roles result in women being the sole caregivers and homemakers. For this reason the ultimate success of an MCNH project relies on women and men understanding the importance of maternal health. With continued work, MAISHA aims to empower communities to support better access to health facilities, facility births, family planning and shared family roles.