January 23 remains etched in the mind of 25-year-old Halima Were, a resident of Shinamurenyi village, Kakamega County.
As dusk set in to usher out yet another productive day, a sharp pain suddenly stung her belly. It had to be something related to her pregnancy, even though her due date was still 20 days away.
And even when it became apparent that she was experiencing labour pains, she could not get a motorbike in time to take her to Matungu Sub-County Hospital, the nearest maternal health facility, 10km away.
After about five hours of fear and excruciating pain, her labour was rewarded bountifully. ‘‘I delivered the first baby, then a second one, followed by yet another one. It came as a shock to me but I was happy that the delivery had turned out well,” said Ms Were.
True to her instincts, all was not well with her bundles of joy – her two sons and daughter were born preterm.
At daybreak, when panic began to get the better of her, she was rushed to Matungu Sub-County Hospital with her newborn babies, on the recommendation of a community health worker. At the hospital, she was told the babies weighed 1.16kg, 1.47kg and 1.67kg, way below the average 2.5kg weight for babies born normally. This prompted the nurses to transfer the babies to the nursery at the New Born Unit.
Mr Patrick Namatsi, a community heath volunteer, said the babies had challenges suckling from their mother because they had been born without the suckling reflex. “The mother had to massage her breasts for the milk and then give it to the babies using a special spoon recommended by the doctors while they were in the nursery,” said Mr Namatsi.
When nothing could attract the triplets to their mother’s breast, Halima, who had given birth twice before, was introduced to kangaroo mother care.
Kangaroo mother care
As the name suggests, the kangaroo mother care (KMC) programme trains mothers to hold their stable preterm and low-birthweight babies in an upright position on their chests to establish skin-to-skin contact for up to 24 hours a day. This stabilises the baby’s cardiac and respiratory activities and increases chances of survival. The kangaroo position also promotes breastfeeding and bonding between mother and baby.
Introduced in Colombia in the 1970s, the innovation has been used in Kenya for about four years and is fast gaining popularity, especially in counties.
“At first, the whole idea was quite a challenge, since managing the three children in turns was quite a nightmare. But after some time, I got used to it and noticed a big change in the health of my babies,” said Halima.
So far, 30 counties have at least one KMC unit each.
Halima and her babies spent a full month at the hospital’s New Born Unit as nurses closely monitored the condition of the babies.
Nine months on, medical records show that the babies have gained weight and are in good health. Baby Bashir is now 6 kilos, Zamira 7.6 kilos and Faraj 6.5 kilos.
Matungu Sub-County Hospital, one of the hospitals in the county with a high number of deliveries, recorded 34 preterm births between January and September 2018. The hospital’s KMC programme also caters to mothers who give birth to low-birthweight babies from the neighbouring sub-counties of Butere and Matayos in Busia County.
These are the fruits of an idea that started in 2015 with the training of a few sub-county hospital health staff, after which a team comprising maternity staff, community health committees and health facility board members were gradually sensitised to popularise the innovation in the whole sub-county.
About 12 percent of deaths of children under five in Kenya are due to premature birth, according to the United Nations Children’s Fund. Many of these deaths occur in rural and remote parts of the country, such as Halima’s Shinamurenyi village, with poorly equipped maternity facilities that lack reliable power to operate incubators.
Thanks to simple innovations such as the kangaroo mother care, lives can be saved.
Rashid Musa, Halima’s husband, a boda boda operator who now has to work twice as hard to feed his bigger family, said he is grateful for the intervention and has never wished away his bundles of joy even when the couple struggles to make ends meet.
“It’s a tough job but I have to be supportive of my family,” said Musa.