Improving Nursing Care for Preterm Babies

Walking into the Bungoma County Referral Hospital’s newborn unit, the bright baby-friendly atmosphere and pink hue gives one a warm welcome. You might even think it is a private health facility. Rosemary Mututa, who is a nurse working here, is in charge of both the Kangaroo Mother Care room and the New-Born Unit.  Rosemary remembers how unfavourable the environment was before these innovations came on board, funded by the County Innovation Challenge Fund. Insufficient staffing, inadequate equipment and limited capacity led to low birth weight babies being discharged at 1300 – 1400 gms, contrary to the recommended 2000 gm. Babies in the New-born Unit (NBU) did not have anyone to care for them at night.

“But with the refurbishment of the NBU by Mount Kenya University, and establishment of a Kangaroo Mother Care (KMC) unit by Save the Children, there’s a significant improvement in the management and survival of (very) low birth weight babies,” Rosemary says. With more state of the art incubators installed, a dedicated NBU in place, refurbishment of the KMC room and amenities such as reclining beds, linen, and feeding cups, it is now easier to care for mothers and their neonates.

Reports indicate a reduction of neonatal deaths in the facility due to increased confidence and skills to handle prematurity infants. This is a milestone that comes after 95 healthcare providers in the county were trained on newborn care by a team of neonatologists from Mount Kenya University (MKU) and the Kenya Paediatric Association.  Moreover, the Althea telemedicine platform introduced by MKU has provided nurses’ with access to specialised neonatologist advice to care for premature babies. In the past, it would not have been possible to care for such babies, as they did not have adequate skills, equipment or guidance.

The referral hospital has adopted an integrated approach, providing seamless levels of care to each infant - both within the facility as well as through a network of facilities in Bungoma county. Very needy infants are admitted in the NBUs, and are then graduated to KMC once they are stable and the appropriate weight. Eventually mothers are discharged with their newborns and receive follow up care at home from a community health volunteer. The hospital has also welcomed other innovations and woven them into this package of care, including the IncuBlanket: a special warming blanket for pre-term infants that does not require electricity. This integrated approach has maximized cost efficiencies, providing each newborn with care at the level required.

Though there is progress, there are also challenges that hinder results. “NHIF’s Linda Mama programme only caters for mothers and babies who have no complications, yet premature babies stay for weeks before discharge. It would be great if Linda Mama covered this so that the neonates can benefit,” Rosemary observes.

The facility continues to advance due to these interventions and service provision is on a positive trajectory.