Sandra Wekesa @wekesa_sandra

For Winfred Muthini, the journey to her local health centre in Mukuru kwa Njenga Slum in Nairobi County started last year when she thought she had abdominal pain only for tests to reveal she was 24 weeks pregnant.

This was the first time she visited a doctor or health professional in regards to her health, despite having a public hospital only about 20 minutes’ walk from her house.

“I had never heard of antenatal and postnatal. From my community, most expectant mothers visit the hospital at seven or eight months of pregnancy, and I knew this was the pattern.

I actually got to go to the hospital when a Community Health Volunteer (CHV) in my area told me the importance of hospital visits while pregnant,” she recalls.  

Having conceived at the age of 19, her understanding of pregnancy was that it was normal and all she required was routine checkup when she was in pain, but that was not the case. 

Detailed checkup

On her second antenatal visit, she was referred to Mama Lucy Hospital for a detailed check-up, however, she did not have money for the tests.

With the help of family and friends, Winfred was able to go to the hospital after a week, that is when routine blood work  established that her and her baby had different blood types, a condition known as RH incompatibility, which occurs in pregnancy when a mother and a child carry different Rhesus protein factors in the covering of their red blood cells.

For her case, she was Rh Negative while her baby was Rh Positive, meaning she was required to take a Rh Immune Globin at 28 weeks during her pregnancy and after birth.

“Even though I went for antenatal clinics late, I am glad I went to the hospital in good time.

Unfortunately, the results took too long to come out and this affected the time that I got the first dose.

During this period of wait, I was really afraid I would lose my baby but at the same time optimistic that everything would be okay,” she recalls.

The dose cost Sh6,500, which she could not raise. It took her about three weeks to fundraise for it. 

Luckily, it did its work and Winfred did not have any complications throughout her pregnancy.

With the help of her CHV, she attended all her clinics and kept to the nutritious foods list provided. 

Unfortunately, Winfred delivered a month before her due date because of low amniotic fluid.

“On that day, I woke up early because I was in so much pain. I spotted blood on my bed and quickly called the CHV.

We walked to our health center and seeing that they were slow to responding, she recommended we go directly to a referral hospital,” she says.

As they were unable to get an ambulance, they used public transport as it was the only available option.

It didn’t take them much time since it was during off-peak hours; with no time they were at Mbagathi District Hospital. 

She was attended to immediately and had a normal delivery. And for Felister Nduku, she had a normal pregnancy with her second child and attended all the antenatal visits. 

This being her second time at birth, she had established contacts with her CHVs, and was certain that if any complication arose, there was help at hand. In addition, they visited her home weekly.

“Given that I was a second-time mom, I had already mastered benefits of antenatal and postnatal visits.

This helped me know how to plan ahead of my little one, and what to expect on the day of the delivery,” says Felister.

But this wasn’t as expected on the delivery day, because she ended up labouring longer than expected and the healthcare workers also took longer to attend to her. 

Long wait

“I sat at the facility for six hours waiting for them to attend to me since they insisted that I had not dilated enough.

The nurse then examined me and said  it was a complication so I needed to go to Mama Lucy Hospital,” she remembers.

Surprisingly, she arrived at the facility and  had a normal delivery.

Adequate maternal healthcare is considered essential for maternal and child mortality.

Kenya has a long way to attain Sustainable Development Goal that targets reduction of maternal and neonatal deaths to 70 maternal deaths in 100,000 live births and 12 neonatal deaths in 1,000 live births annually.

This cannot be achieved without proper structures in place.

Faith Nzula, a CHV at Mukuru says, about six years ago, the only accessible hospitals within the area were dispensaries at Kayole and Embakasi. 

“This was a challenge because sometimes we would accompany expectant mothers to the clinic.

It meant using our own transport or walking with them as they attended their antenatal visits,” she recalls.

She says the situation forced most mothers to resort to home births, leading to an increase of unskilled midwives in the community.