Hildah with her baby son in Kenya.
On an evening in July, Hildah went to the Kitale County Referral Hospital in western Kenya complaining of abdominal pain. Two hours later, she was a new mother. Hildah’s labour was short but difficult. “I was in a lot of pain, and I was afraid,” she said. Her baby was in a breech position, complicating the delivery.
In order to safely deliver the baby, Hildah needed a routine surgical incision during labour. She was frightened, but her nurse, Floridah Otoli, explained why it was necessary and reassured her that she and her baby would be fine. The procedure went smoothly.
Two days later, at home with her baby son swaddled and sleeping peacefully in her arms, Hildah was grateful despite her ongoing discomfort from the delivery. ”At the hospital I received good care,” she said. “If I had not gone there, things could have gone really badly. The pain would have been worse, and I could have died.”
Through the System Enhancement for Transformative Health (SETH) project, health workers at Kitale County Referral Hospital receive on-the-job training, mentorship and education to improve the quality of maternal, neonatal, and child health care service delivery.
Floridah is one of the staff members participating in the program, and she now passes the benefits along to mothers like Hildah. In addition to being coached on how to provide sensitive care to expectant mothers, Floridah has learned hard skills including how to monitor expectant mothers with antenatal issues, manage pre-term deliveries, properly measure dilation during labor, assess for problems like deep vein thrombosis, and perform physical examinations to evaluate mothers’ and babies’ condition after delivery.
Floridah Otoli, a nurse at Kitale County Referral Hospital in western Kenya.
“I feel I’m better prepared because now I have the skills to detect deviations from what is normal,” Floridah said. “When I find an issue that may have been previously missed, I can manage it or refer it appropriately.”
During Hildah’s time in the hospital, Floridah not only kept Hildah and her baby safe – she also helped her learn how to take care of her newborn. Floridah showed Hildah how to breastfeed the baby, as well as how to wrap her in a swaddling cloth for better, safer sleep. She instructed her to come back to the hospital in two weeks and again in six weeks, for check-ups and pediatric immunizations to ensure that both mother and child would continue to do well. “I feel that the advice the nurse gave me will help me take care of the baby, ” said Hildah.
A soft-spoken young woman facing single motherhood with little parental support, she now lives with her older sister in a simple two-room home. Her sister provides moral support but has no experience raising children, so the compassionate, thorough care and confident advice that Hildah received from Floridah and other hospital staff is a lifeline.
The SETH project – which is implemented by Action Against Hunger and Helen Keller International with the financial support of Global Affairs Canada – aims to strengthen the health system and improve maternal and child health outcomes in Kenya. The project has trained more than 800 health workers in 5 Kenyan counties to improve the quality of care, which has led to an increase in the number of women who seek services.
According to data from a national scorecard, between 2016 and 2018, the number of pregnant women in Hildah’s region who received at least four antenatal care visits rose from 37 to 43 percent. During this same time period, the number of women who had skilled deliveries went from 54 to 59 percent, and the number of women who received postnatal care increased from 5 to 33 percent. At Kitale County Referral Hospital, Floridah reports that the staff can attend to 30 pregnant women with standard deliveries and up to ten C-sections per day. It’s a lot of work for a smalI hospital, but Floridah says that with the support of the SETH project, they can provide their patients with the care they need.
The benefits of the project ripple out to the entire community. “I feel empowered,” says Floridah. “I am better placed to give services, so that at the end, we have a healthy mother and a healthy baby. And if we do that, we also have a healthy nation.”
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