Panic as antenatal visits dip across county hospitals

Lilian Kaivilu @liliankaivilu

As the Covid-19 cases keep rising by day, maternal health in some counties in come counties is already experiencing a blow with fewer mothers attending antenatal clinics. Hospital deliveries are fewer, too. 

Kericho County Referral Hospital, for instance, recorded one delivery in 24 hours immediately after the Ministry of Health announced the first Covid-19 positive case.   

Here, deliveries have dropped from 35 to 15 per day. Caroline Chelagat, the nursing officer in charge of maternity services at the facility, blames it on fear among mothers as they see health facilities as possible transmission centres for the deadly virus.

“Previously, we would get up to 120 mothers in a day bringing their children for immunisation, but yesterday we had only 40,” says Chelagat. 

The trend, she opines, might adversely affect the immunisation and deliveries indicators. 

According to her, antenatal visits have also dropped significantly. “For the first antenatal care (ANC) visit, we would record between 5,500 and 6,500, but now we are recording 3,500 at the fourth ANC. We are now worried that this may get worse.”

Salina Bitok, nursing officer at Kapsabet county referral hospital says although the number of mothers coming to the hospital has not changed much, the facility has beefed up basic hygiene standards and physical distancing in the maternity ward.

“We are keeping good distance between the beds in the maternity wing. We also have a good supply of good supply of essential commodities such as gloves and surgical masks,” she says. 

The facility has now started mandatory screening for anyone visiting the health facility.

If one’s temperature exceeds 38.5 we send them for a check-up. At the screening tents, Bitok adds, there are strict rules on the distance from one patient to another. 

Police brutality

In Kwale county, the health department is already mapping pregnant women to ensure that the ongoing curfew does not bar them from accessing health services.

Dr Jumaa Mbete, the county Chief Officer for health, however, says fear of police brutality among the locals still remains a challenge.

“Women who are pregnant and their bellies cannot show are most at risk because they may be beaten or arrested by the time they show proof of pregnancy, which is also indecent in itself,” says Dr Mbete. 

While the closure of some health facility in readiness as coronavirus response centres is a welcome idea, Phidelis Wamalwa, Monitoring Evaluation Research and Learning Advisor at Options, says community sensitisation is key.

“That’s a good step in that Covid-19 patient will not have to interact with ordinary patients. But there is need to communicate to expectant mothers and patients coming for their routine fill up of their TB and HIV drugs.

Proper management of their health records is also important in a case that a health facility has been shut down,” she says. 

Wamalwa says dealing with Covid-19 should not put to halt other essential health services.

“There needs to be proper distribution of healthcare workers across the counties.

We don’t want a situation where a gynecologist is stationed at a Covid-19 response facility when a mother in another facility is facing maternity complications with no specialist to attend to her,” says Wamalwa. 

UNFPA-Kenya Reproductive Maternal Newborn, Child and Adolescent Health senior programme coordinator Dr Rael Mutai, emphasises on the need for the respective county governments to prioritise maternal health services as an integral component of the Covid-19 response and allocate resources to meet the needs of the local population during this crisis.

In this regard, she added, UNFPA currently provides technical support to Government counterparts in the planning, implementation and monitoring of the Covid-19, including generation of data and analysis to inform decision making, particularly pertaining to sexual and reproductive health and rights. 

Early April, the World Bank, through the Kenya Covid-19 Emergency Response Project, approved a $50 million (Sh5 billion) funding to support Kenya’s response to coronavirus, with $10 million (Sh1 billion) of the funding going to blood products.

“Blood is core to all clinical aspects of health systems. $10 million (Sh1 billion) of this funding will go towards strengthening the capacity of the Kenya National Blood Transfusion Service to provide safe blood and blood products,” said Jane Chuma, senior health economist and task team leader.