In a desperate bid to get to a hospital, a young woman dies a lonely death in a taxi just before giving birth. She has neither the money nor support to reach medical help in time.
Sadly, such needless losses occur too often in remote and disadvantaged parts of the world.
Impediments to the wellbeing of mothers-to-be lie beyond the “three delays” in seeking medical attention, reaching health facilities, and receiving quality care. In rural Kenya, many communities have not placed adequate emphasis on the importance of planning and attending to childbirths, especially in face of the rising pregnancy-related deaths in the country. Combined with meager personal resources available in case of emergencies, pregnant women often give birth at home, unable to seek rapid transport to higher levels of care if needed, which endangers the moms’ and the babies’ lives.
Perceiving this critical fourth delay in community mobilization in the event of childbirths, innovators at Kenya’s Moi University School of Medicine now aim to stimulate proactivity across all community levels to assist and care for their mothers and infants.
The solution to the challenge, according to the team, lies within the inherent strength and existing networks of the community itself.
“In our community, women care a lot about each other,” remarks Dr. Julia Songok, an experienced pediatric consultant who is leading the research project. “…Our strategy is to actually hold the community accountable: the chief, the mothers and the other peer groups as well as the health facility, and in the long-term, have a sustainable community-driven solution in maternal and newborn health.”
At the heart of this solution is a Mother-Baby Health Network to enable quality service delivery, and promote demand creation. In a part of the world where cell phone are pervasive, it’s a high-tech solution to the age-old issue of maternal health. The team plans to benefit from the widespread connectivity and availability of inexpensive smart phones to foster rapid communication among all key stakeholders within the community network. Community health workers will receive Android phones installed with clinical decision-support applications to effectively triage patients for referral to higher levels of care.
In addition, the community health workers will encourage women to take advantage of their innate peer support structure by pre-identifying a personalized list of “Mother-Baby Advocates” as emergency contacts, which will also be stored in the mobile triage system.
Finally, a group of private taxi drivers will be certified as “Mother-Baby Taxis”. They will serve an integral role in an SMS-triggered emergency alert system that links the GPS-tracked Mother-Baby Taxis with community health workers, health facilities, Mother-Baby Advocates, and community leaders, and empowers the community to act readily to birth-related emergencies.
For the solution to work, communities will need to value the health of the mother and baby enough to compensate the Mother-Baby Taxi for rapid transport of women to higher-level health facilities – thus elevating the value placed on healthy birth within the community. Public recognition of action and leadership that contributes to healthy deliveries will be used to promote this community and health system accountability for every mother and newborn life.
Dr. Songok is confident that the Mother-Baby Health Network will not only facilitate dialogue within the community but also engage members at all levels to be accountable for maternal and newborn care. She anticipates that an “increase in the number of facility deliveries and visits within 48 hours of birth by 50% in a population of 200 thousand people” will be achieved with this approach.
I would like to acknowledge and thank Lyn Whitham for her roll as a contributing author of this piece.
− Siqi Xue (Twitter @siqixue).