Is he jinxed or is the health care system wanting?  Twice , Amos has lost the mothers of his two sons immediately after birth as a result of postpartum hemorrhage or excessive bleeding after delivery, and the second time his wife died of pre-eclampsia a condition that is characterised by high blood pressure which leads to multiple organ failure and is  most often fatal.  His wife’s condition was further escalated by the fact that they took time before seeking medical interventions.  Both times they had sought the services of TBAs or Traditional Birth Attendants as it was cheaper and more convenient according to them.  Now Amos is left to look after young Mark all by himself while the elder son is living with his late  first wife’s relatives. Is there a possibility that these two untimely and unfortunate deaths could have been avoided?

Women continue to die in childbirth because they don’t access  the essential ante-natal and maternal health care.   A woman is recommended to at least attend 4 ante-natal visits as it is important in the management of maternal complications as well as for providing essential services such as tetanus immunization, iron and vitamin supplements and nutrition education.  Apart from attending ante-natal care the quality of care received  does play a key role in the health of the mother and her unborn child, timely and frequent visits can help identify potential pregnancy complications which could be detrimental in a mother and her baby’s health. It is generally recommended that ante-natal visits be made monthly during the first seven months, fortnightly during th 8th month, and then weekly until delivery.

Poor ante-natal care is a risk factor for adverse pregnancy outcomes for both the mother and baby,and includes maternal mortality, perinatal mortality, premature delivery and low birth weight. However, some women continue to seek the services of TBAs  because of various socio-economic challenges which include poverty, accessibility of health facilities among others.  The government had at one time sought to train and work closely with TBAs,  with an aim of  reducing the rate of maternal mortality. Nevertheless, despite the efforts and resources used to train TBAs,maternal mortality has not been reduced.  Women may not be aware of the deficiencies in  TBAs’ skills and the potential risk to themselves and their unborn babies. Currently maternal health remains a big challenge in Kenya despite having reduced from 414 to 410/100,000 as indicated in the Kenya Demographic Health Survey 2008. The KDHS survey also indicates, that the child survival rate has improved despite the high number of newborn deaths.

Causes of maternal deaths, such as abortions,ante/postpartum hemorrhage,postpartum sepsis (infection),  pre-eclampsia, prolonged labour, HIV and anaemia, can easily be avoided if women are empowered against seeking the services of TBAs. Most of these TBAs don’t consider their lack of training an issue which is more dangerous as they could not only endanger their lives, but also put at risk the lives of the mother and her baby especially where one of them is infected with the HIV virus. As much as they have proved to be helpful in some situations, there is need to do away with their services and instead encourage women to seek proper care in health facilities.  Retired midwives could be deployed to cover the gap in the shortage of human  resources, as they are already well versed in handling emergency situations which could lead to untimely deaths.