Presentation at the Global Maternal Newborn Health Conference, October 20, 2015
Background: Home delivery is a cultural norm in Samburu County which is exacerbated by long distance to health facilities, poverty and illiteracy. Skilled birth attendance is important in reducing maternal mortality yet the proportion is low at 19% as compared to 62% nationally. International Medical Corps (IMC) has been supporting the county health department to improve maternal and child health through capacity building of health workers since 2011. Mother to mother support groups were also initiated at community level to promote good infant and young child feeding practices. The groups identified the lack of a maternity as a major problem affecting women in Nachola Village, with the closest being twenty kilometers away.
Methodology: In 2013, nine group members took the initiative to construct a maternal shelter to house maternal health services. This would be located adjacent to the MOH supported dispensary. With support from IMC, group members were mobilized to contribute locally available construction materials. Pregnant women were also sensitized about the shelter through mother support groups meetings at community level, by community health workers and referrals by other mothers. The services provided include antenatal care, birth plan preparation, delivery and postnatal care provided by a nurse/midwife recruited by the county health department. Complicated cases are referred to the next level for management.
Results: Skilled delivery at Nachola dispensary was 27% in 2014, 13% in 2013 and 0.6% in 2011.This shows an increasing trend as compared to the overall 19% for the county. It has also provided an opportunity for education on nutrition, immunization, breastfeeding, family planning etc. provided by the nurse/midwife. Some communities in the neighbouring Turkana County have since learnt about the maternal shelter and replicated it.
Conclusion: The maternal shelter is a useful intervention to increase skilled deliveries in remote areas and could be easily replicated.