Traditional birth attendants contribute to infant deaths

Traditional birth attendants (TBAs) in Nakuru County are believed to be a leading cause of infant deaths.

In communities where the TBAs are still part of their cultural practices, they have a high social standing especially where deliveries are done at home as opposed to a health facility.

But what is of great concern is that most of these TBAs contribute to increased maternal and perinatal mortality rates since they mainly rely on traditional practices some of which are harmful to the mothers and their babies.

At the same time, most are concerned with earning a living from their practice and therefore do not consider the dangers they may be putting expectant mothers and the unborn babies into.

PRACTICE SECRETLY

The TBAs, who mostly practice secretly, keep new mothers away from proper medical attention offered at health facilities for more than a week in order to earn more and hence deny the infants the needed care.

Some have even admitted that they have let infants whom they know are having serious complication stay under their care.

“The more they stay with us, the more money we earn.

They pay at least Sh400 a day and in a week this translates to Sh2400.

This is enough for me to push through another week,” said Jane Wangechi (not her real name), a TBA in Mai Mahiu.

Wangechi admits that majority of the women in the area prefer to go to them since the nearest hospital is more than 50 kilometres away.

She also admits that she has never received any training on child delivery and maternal healthcare but learnt the practice by watching other women do it.

Even when they notice a possible complication in the infants, the cunning TBAs would normally not inform the mothers, since they will most likely run away to a different TBA.

INFANTS DIE

Wangechi admits that in her “clinic” at least four infants die in a month owing to birth related complications.

On a normal day, she attends to more than ten women from the area.

“We ensure that we scare our patients so that they don’t go to hospitals.

We tell them stories of how expectant women are beaten by nurses or abused when they go to hospitals.

We take advantage of the fact that they are illiterate,” she added.

In Ndabibi area, Lucy Wanjiru (not her real name), also a TBA, uses religion to discourage expectant mothers from going to hospital.

RELIGIOUS BELIEFS

She takes advantage of the fact that many belong to a religious sect that considers getting modern medical attention as sin.

“It’s a new way to earn a lot of money.

These women are rich and they can afford to pay me well. I do not want to have this money taken to a hospital which is in any case too far,” she added.

Wanjiru says that she loses about six infants in a month but her patients take it as “Gods will” due to their religious beliefs.

Recently, there were reports of mothers, some from Nakuru County, who were arrested for failing to have their children vaccinated against polio saying this was against their religious beliefs.

She serves at least twenty patients in her ‘clinic’ in a ‘good’ day and has one assistant to help her. She charges between 400 and 500 depending on the “ability of the parent.”

According to her, the high number of women who give birth in the area has encouraged her to increase her charges.

Many women in Kongoni, Naivasha, Ndabibi, Njoro Molo areas still believe that TBAs offer the best services.

The women argue that they prefer their cheap charges as compared to the cost of transport they would incur while going to hospitals which are far.

MORTALITY RATE

It is estimated that eight per cent of the children born in Kenya die in infancy.

Uganda has an infant mortality rate of six per cent while Tanzania has a rate of eight per cent.

According to the Naivasha Social and Welfare officer Esther Njeri, the increased cases of women giving birth at homes was solely to blame for the increased infant deaths in the area.

She says that religion plays a key role in discouraging women from giving birth in hospitals.

“Most fear that they will receive the wrath of God in case they go to hospitals.

Some are still tied to the belief that they are desecrating their bodies by going to hospital,” she says.

“In most cases we get a very harsh reception when we go to advice women to give birth in hospitals.

Many argue that it is their bodies and they can do whatever they wish with them.

In Nyandarua, drug abuse among women has also contributed to reduced uptake of modern maternal healthcare.

DRUG ABUSING MOTHERS

Nyandarua south District Children Officer David Koigi says that majority of mothers who abuse drugs preferred to go to TBAS since they feared being intimidated by nurses.

According to Koigi, the increased usage of bhang in Nyandarua has pushed many women to abandon prenatal and post natal care at hospitals in favour of older women who act as birth attendants.

“They are allowed to go to the TBAs while smoking bhang or even when chewing miraa.

This cannot be allowed in the government hospitals,” he adds.

He further says that some of the mothers are believed to even collude with the TBAS to kill the infants especially when they get a child of a gender they did not want.

“Majority of the women want a boy so when they get a girl they tell the TBAs to kill the child. This has pushed the number of infant deaths in the area,” he added.

According to Naivasha District Hospital Superintendent John Mburu, TBAs still practice their trade especially in the rural areas.

“We have tried to hunt for them but they do it secretly.

We have even tried to get pregnant women to pose as clients looking for them but they are very discreet,” he added.

ONLY AFTER MONEY

Mburu argues that majority of the TBAs were only after money but not after the interests of the child and the mother.

He says that simple problems that can be diagnosed in case a woman delivers in hospital are ignored by the TBA, hence leading to either the death or the deformity of the baby.

“We have tried to get them to dialogue with us.

Majority of them can even know when a child is having fever or malaria soon after birth.

Or when the child has complications but since they want to earn extra they prefer keeping the child at their care,” he adds.

According to the Kenyatta National Hospital senior gynaecologist John Onge’ch, infants still need specialised care that is only offered in hospitals.

“Women need to understand the importance of going to hospital.

We intend to start an outreach programme for women in rural areas and advise them on the importance of giving birth in hospitals,” he added.