MNCH

Kenya has made notable progress in improving maternal and child health outcomes. However, despite the progress, Kenya could not achieve the Millennium Development Goals for maternal and child health. 

It is clear that a lot more still needs to be done by Kenya to address the supply and demand side barriers in the delivery of essential health services in order to realize the goals of Vision 2030 and the 2010 Constitution. The Bill of Rights clearly articulates the right to health for all, including reproductive health. 

There have been notable improvements in service delivery during the past three years in Kenya. The county governments have given priority attention to expanding primary health care networks and enhancing effectiveness in service delivery. 

Access to emergency obstetric care has improved in counties that faced long-standing challenges in making facilities operational. However, more focused effort is required to eliminate preventable maternal and child deaths and improve health outcomes.

Capacity building of MHUs in MNCH
In 2016, CHAK with support from Bread for the World in collaboration with the Ministry of Health (DRH) and Micronutrient Initiative organized training for health care workers on the Essential Newborn Care and Basic Essential lifesaving skills for MNH/Basic and Comprehensive emergency Obstetric care (BEmOC/CEmOC).

Broad objective of the training
The main aim of the essential newborn care (ENB) and BEmOC&CEmOC training was to equip the service providers with updated knowledge, skills and appropriate attitudinal concepts to enable them improve quality in provision of maternal and neonatal emergency care in their health facilities. A total of 29 participants drawn from 29 MHUs were trained on BEmOC&CEmOC while 122 were trained in ENB care.  

Lessons learned

1. Implementation of ENB and BEmOC/CEmOC interventions requires open dialogue between the community and health care system at all levels.
2. Addressing the three delays through community sensitization, advocacy and networking, improvement of referral systems as well as availing basic equipment and supplies to both the BEOC & CEOC facilities to effectively manage the emergencies and referrals is a pre- requisite to improvement of MNH care.
3. Effective leadership and supportive supervision is a basic requirement to elimination of the third delay at the facility level. 
4. Building a critical mass of skilled service providers in management of obstetric emergencies is a basic need to improving the MNH care
5. Establishing emergency teams and protocols is a positive step towards improving MNH care. 
6. A successful BEmOC and CEmOC skills training requires competent facilitators, adequate training resource materials/aids, commitment of both the facilitators and trainees and effective management support. 

Suggestions for improvement of MNH care

1. It is important for all health facilities to ensure availability of drugs, supplies and equipment required for preparedness and prompt action in managing emergency cases especially KIWI and MVA kit. 
2. It is important to print and avail the latest MOH Emergency Obstetrics and Newborn Care Guidelines in the service delivery areas in all health facilities.