The Kenyan Medical Practitioners and Dentists Board has stopped the NGO Marie Stopes International from performing abortions in Kenya. Marie Stopes is a global organisation that provides contraception and safe abortion to women in urban and rural communities. Abortion is illegal in Kenya, unless a trained medical professional judges that there’s a need for emergency treatment, or that a woman’s life or health is in danger.
The Conversation Africa’s Moina Spooner spoke to Michael Mutua about the Marie Stopes ban and its implications.
How did the ban come about?
According to the Kenya Medical Practitioners and Dentists Board, they banned abortion services provided by Marie Stopes following complaints from the general public. The public claimed the organisation was running pro-choice media campaigns. These adverts specifically sought to provide women with a solution when faced with crisis pregnancies.
The adverts were also criticised by the Kenya Film Classification Board, which ordered Marie Stopes to pull them down for allegedly promoting abortion.
Sasha is 22-years-old. She was married off when she was just nine and by the time she was 11, she was pregnant with her first child, and unprepared for childbirth.
So when labor came, in the middle of the night – in her geographically isolated village in rural Kenya – she was unaware of the painful fate awaiting her.
During childbirth, the baby’s head was too big to fit through Sasha’s pelvis, causing the baby to get stuck in her birthing canal. Traditional birth attendants tried their best to help Sasha but they were not skilled enough to handle the complications. She needed surgery, and quickly. But because she could not access emergency obstetric services, she spent the next six days trying to push out the baby that was stuck inside of her.
In the end, Sasha delivered a dead, rotten baby in macerated form. She was not only in grief of her lost child, but was also traumatized by her experience which left her with profound injuries and a double obstetric vaginal fistula.
About 21 pregnant women die every day in Kenya due to complications from childbirth. That’s equivalent to two 10-seater commuter micro minibuses, known as matatus, crashing every day with the loss of all the passengers on board.
Pregnant women in Kenya die because they either do not receive appropriate care during pregnancy or are unable to deliver with the help of skilled health attendants.
Mother’s milk has an enormous impact on child survival. While in Kenya it has improved over the past decade, the number of children who die before five years remains significant. The rate has decreased from 115 per 1000 live births in 2003 to 52 in 2014.
Neighbors Rwanda (2008), Tanzania (2012) and Uganda (2011) have recorded 50, 66 and 65 deaths per 1,000 live births for children below five years, respectively.
The main causes of childhood deaths are infections, preterm births and lack of sufficient oxygen, or asphyxia.
Breastfeeding infants on breast milk alone until they are six months old has been shown to reduce child mortality. When mothers can’t provide their own milk, the next best alternative is donor milk from other women. Access to “human milk banks” gives vulnerable infants, without access to their mother’s own milk, a healthy start to life.
The milk bank concept was initiated in Vienna in 1909 and was preceded by a century old practice of wet nursing – a mother breastfeeding another mother’s child.
Since then, over 500 human milk banks have been established in more than 37 countries globally in developed and developing countries. The pioneer countries include Brazil, South Africa, India, Canada, Japan and France.
There’s a growing global recognition of proper infant nutrition in the child’s first 1000 days of life. This can be monitored through encouraging proper nutrition during pregnancy and the first two years of life for optimal growth, health and survival.
Poor breastfeeding and complementary feeding practices are some of the common causes of malnutrition in the first two years of life. Breastfeeding confers both short-term and long-term benefits to the child like reducing the risk of infections and diseases like asthma, obesity, and type 2 diabetes. Mothers who breastfeed also lower their risk of developing breast and ovarian cancer, weak bones, obesity and heart diseases.
For countries to reap the benefits of breastfeeding they need to achieve a baby friendly status. Kenya began promoting the baby friendly hospital initiative approach in 2002. It ensures that health facilities where mothers give birth encourage immediate initiation of breastfeeding and exclusive breastfeeding for the first six months. Unfortunately, this programme was only accessible to women who delivered in the health facilities, leaving out those who give birth at home.
We conducted a two year study involving 800 pregnant women and their respective children in a rural area in Kenya. The study involved testing feasibility and potential effectiveness of the baby friendly community initiative (BFCI), whereby women in the intervention arm were given home-based counselling on optimal breastfeeding alongside health facility based counselling. These mother-child pairs were followed until the child was at least six months.
Caesarean sections have been lifesaving procedures for hundreds of thousands of women across the world who experience complications during labour.
Globally, it’s estimated that just under 20% of births take place via caesarean section – a percentage that’s gone up over the last three decades. This has raised concerns, particularly in high-income countries where generally too many caesarean sections are performed.
But in many African countries women who are medically required to have caesarean sections are not able to access them. This is due to several reasons, the most prominent being weak health systems and a lack of resources.
This needs to be fixed as women in sub-Saharan African suffer from the highest maternal mortality ratio in the world. Close to 550 women die for every 100 000 children that are born. This amounts to 200 000 maternal deaths a year – or two-thirds of all maternal deaths per year worldwide.
Every day 800 women die during childbirth or from pregnancy complications. This startling statistic represents women who not only live in sub-Saharan Africa where most maternal deaths occur but also throughout the world. In order to reduce the number of maternal deaths in low- and middle-income countries across the globe design teams, social entrepreneurs, innovators, and NGOs are creating innovative ways in which to save more … Continue reading 5 Maternal Health Interventions That Save Mothers’ Lives
Imagine going through your day without ready access to clean water for drinking, cooking, washing or bathing. Around the world, 663 million people face that challenge every day. They get their water from sources that are considered unsafe because they are vulnerable to contamination, such as rivers, streams, ponds and unprotected wells. And the task of providing water for households falls disproportionately to women and girls.
I have carried out research in India, Bolivia and Kenya on the water and sanitation challenges that women and girls confront and how these experiences influence their lives. In my field work I have seen adolescent girls, pregnant women and mothers with small children carrying water. Through interviews, I have learned of the hardships they face when carrying out this obligatory task.
An insufficient supply of safe and accessible water poses extra risks and challenges for women and girls. Without recognizing the uneven burden of water work that women bear, well-intentioned programs to bring water to places in need will continue to fail to meet their goals.
So, what is it like for women who live in places where sufficient and safe water is not readily accessible?
We are very pleased and excited to announce our new weekly chats all about maternal health with some of the leading maternal health experts, researchers, practitioners, and organizations in the world under the #maternalhealthchat hashtag. Starting on Tuesday, November 8 at 1 PM EST with Jacaranda Health we will host 30-minute chats each week all about maternal and reproductive health as well as the health of newborns. We will dig … Continue reading Announcing #MaternalHealthChat Starting November 8 With Jacaranda Health
Every year just over 500,000 women die from complications in pregnancy and childbirth across the world. Another 20 million experience severe complications. But many of these complications are entirely avoidable – including obstructed and protracted labour and one of its side-effects, obstetric fistula.
An obstetric fistula is a hole in the birth canal between the vagina and the rectum or between the vagina and the bladder that is largely caused by obstructed and prolonged labour. This can occur when the mother’s pelvis is too small or the baby is too large.
In sub-Saharan Africa for every 100,000 deliveries there are about 124 women who suffer an obstetric fistula in a rural area. Obstetric fistulas predominantly happen when women do not have access to quality emergency obstetric-care services. Antenatal care could help to identify potential problems early but will not have an impact if there is no skilled surgeon to assist with the labour.
South Africa has extremely high maternal mortality levels. This is true when compared with developed countries as well as other developing countries.
According to the World Health Organisation, for every 100,000 live births in the country in 2015, 138 women died due to pregnancy and childbirth complications. In Sweden, fewer than five women die for every 100,000 live births. In Brazil, the estimate is 44 women for every 100,000 live births.
Launched four years ago, the two clinical trials, known as ASPIRE and The Ring Study, set out to determine how safe and effective the ring was in prevention of HIV infection in women. The ring, which is used for a month at a time, contains an antiretroviral drug called dapivirine that acts by blocking HIV from multiplying.
The studies enrolled close to 4500 women aged 18 to 45 in South Africa, Uganda, Malawi and Zimbabwe. Each study found that the ring helps reduce the risk of HIV infection in women. In ASPIRE, the ring reduced the risk of HIV infection by 27% overall. In The Ring Study, infections were reduced by 31% overall.
Sub-Saharan Africa has the highest level of food insecurity in the world. An estimated 220 million people lack adequate nutrition. The nature of the problem is shifting rapidly, with overweight status and obesity emerging as new forms of food insecurity while malnutrition persists. But continental policy responses do not address this changing reality.
Food insecurity is the outcome of being too poor to grow or buy food. But it’s not just any food. According to the United Nations’ Food and Agriculture Organisation’s definition, people need:
… sufficient, safe, nutritious food to maintain a healthy and active life.
Current policy focuses on alleviating undernutrition through increased production and access to food. It does not focus on the systemic issues that inform the food choices people make. This may result in worsening food insecurity in the region.
Over the past decade there has been growing research that purports the long-held belief that Voluntary Medical Male Circumcision (VMMC) can drastically decrease the rates of HIV, sexually transmitted diseases, and urinary tract infections in low-and middle-income countries. In Tanzania, for example, where these photos were taken at an IntraHealth International mobile clinic, HIV can be reduced by sixty percent leading to a AIDS-free generation. … Continue reading Photo Essay: Standing in Line for Voluntary Male Circumcision
For two years Ebola has drastically ravaged three West African countries – Sierra Leone, Guinea and Liberia – and has taken the lives of 11,300 people according to the Guardian UK. Over 28,000 people were diagnosed with Ebola and still live with the pain and stigma of the disease. Since Liberia has not reported a single Ebola case in 42 days, the World Health Organization officially declared an end to the Ebola epidemic. Sierra Leone and Guinea have already been declared Ebola-free with 90 days of no new reported cases. However, just last week another Ebola case was discovered in Sierra Leone in the death of a 22-year-old woman, causing an outbreak of at least 100 people. Twenty-eight people have been quaratined.