On Friday, 06 November 2015, we had the honor of joining the First Lady of Kenya Ms Margaret Kenyatta, a tireless advocate for “every woman and every child”, for the launch of the Beyond Zero campaign in Mandera County in north-eastern Kenya, which has often been described as ‘the worst place on earth to give birth’.
Mandera’s maternal mortality ratio stands at 3,795 deaths per 100,000 live births, almost double that of wartime Sierra Leone at 2,000 deaths per 100,000 live births.
Two out of every three cases of maternal deaths occur in areas affected by a humanitarian crisis or fragile conditions, such as the North-Eastern region of Kenya where increasing focus is being put to give pregnant mothers a fighting chance to survive child birth.
The region contributes close to 6 out of every ten maternal deaths. Low education, low contraceptive use, inimical cultures such as FGM and child marriage, that derail women’s self-determination and inadequate health services have kept the region perpetually posting poor health indicators.
What we realized was that almost every child-birth here is a throw of the dice, a hit-or-miss proposition that local communities face with stoicism, but a situation that development agencies are increasingly determined not to sit and watch.
For just over a year now, UNFPA has worked with the H4+ partners (UNICEF, WHO, World Bank, UN Women and UNAIDS), to find ways not only to save lives at childbirth but also to meet related challenges of reproductive health in the six counties of Kenya bearing the greatest burden of maternal deaths.
The government of Denmark supports UNFPA’s programmes globally and in Kenya this support is based on a Denmark-Kenya Country Programme 2016-2020 that seeks to give momentum to Kenya’s Vision 2030.
The policy’s thematic programme on health specifically identifies operational support for primary health care facilities at county and national government levels as well as support for sexual and reproductive health and rights.
This is the basis on which the government of Denmark is committed to supporting UNFPA to further their ongoing work in Mandera, Marsabit, Wajir, Isiolo, Lamu and Migori to deliver a comprehensive package of services in reproductive, maternal, newborn, child and adolescent health.
Denmark has pledged US$ 6 million to help the six counties give more focus on adolescent girls and young women, through targeted and evidence-based interventions in multiple sectors. Of key concern will be addressing drivers for early sexual debut among adolescent girls and boys, early childbearing and early marriage, and advocating for keeping girls in schools.
In a demonstration of how collaboration in development work must be done going forward, various private sectors partners have joined the efforts in the 6 counties, with initial signs that there will be good outcomes as a result of all the efforts brought to the table.
There is reason for optimism that we can expand the supply of quality services; that we can innovate for delivering cost effective interventions for family planning, emergency obstetric care, postnatal and newborn care.
Though it is the right thing to do, this partnership is not driven by moral positions, but concrete evidence that reducing maternal and newborn deaths is the smartest investment for turning around the fortunes of poor economies.
Our observations show that no complex undertakings are required to make a real difference; simple interventions such as ensuring more women give birth through a skilled attendant greatly increase chances of survival for mother and baby.
It is about convincing communities to eschew practices such as FGM and early marriages that invariably occur without the girls’ consent, robbing them of their childhoods, forcing them out of school, trapping them in poverty, and putting them at high risk of dangerous pregnancy and childbirth.
It is about empowering women to plan whether and when to have children, thereby putting them at good stead to complete their education, to increase their earning power and to reduce poverty.
It is also about exploiting local resources, working with structures that local communities are comfortable with. In Wajir County for instance, local community health volunteers have been trained to identify pregnant women within clusters of around 10,000 people, and link them to the health facilities to receive antenatal care services.
The volunteers provide health education to the pregnant mothers on the importance of antenatal care services, the knowledge and importance on how to recognize danger signs during pregnancy, during delivery and post-delivery.
Already, deliveries under skilled care are going up, anchored as well by the Kenya government’s free maternity care scheme.
Global data shows that the highest benefits from reducing unintended pregnancies would accrue to the poorest countries, with GDP increases ranging from one to eight percent by 2035. There are few interventions that would give as wide-reaching impacts.
Sure as we are about the steps needed however, it is a window that will not remain open forever and the urgency of the moment cannot be over-emphasized.
Ms Mette Knudsen is Denmark’s Ambassador to Kenya. Follow her on twitter: @metknu. Siddharth Chatterjee is the United Nations Population Fund (UNFPA) Representative to Kenya. Follow him on twitter: @sidchat1