Together We Can Help Preterm Babies Survive, Thrive and Transform

Though Kenya has made remarkable progress in reducing child deaths over the last decade, a lot more effort is needed to further reduce this. Prematurity is the leading cause of death among children under five in Kenya and globally. We talked to Dr. Warfa Osman - the Head of the Newborn, Child and Adolescent Health Unit in the Ministry of Health (MoH) – about the current prematurity situation and the steps the government is taking to address it.

What is the latest situation in regards to preterm and low birth weight births in Kenya?

In Kenya, 193,000 babies are born too soon annually and 9,670 children under five die due to direct preterm complications. That is about 26 child deaths every day. According to our estimates, prematurity and low birth weight account for about 12% of the deaths of children under five and about a quarter of neonatal deaths. In fact, Kenya is ranked number 15 out of 188 countries in terms of the burden of premature births. Prematurity is also a major contributor to childhood and long-term disability including motor, cognitive, psychosocial, and other developmental problems.

What is the government doing to address the problem?

We are taking a multi-pronged approach that includes scaling up proven interventions to address risk factors and enhance clinical management of premature babies. Our focus is ensuring that all mothers receive quality care from skilled providers during pregnancy and childbirth, giving higher priority to preventing premature and low birth weight births. By improving access to quality antenatal care, we are ensuring more mothers have their pregnancies monitored including foetal growth, screening and addressing risk factors, improving maternal nutrition and providing counselling for a positive pregnancy experience.  We are in the process of adopting the World Health Organization’s recently released guidelines and recommendations to improve the quality and outcomes of antenatal care. We are putting more emphasis on addressing maternal anaemia using Iron and Folic Acid Supplementation for pregnant women; scaling-up Kangaroo Mother Care as part of a comprehensive package of essential newborn care; and a greater focus on improving access and utilization of contraceptives. We’re also working closely with county governments to improve the health system capacity to offer accessible, quality and equitable antenatal and intrapartum care.  

These initiatives are parts of our bigger ambition to achieve universal health coverage, and I think we are on the right path. For instance, the Linda Mama programme is reaching more mothers with free maternity care and we are working with the National Hospital Insurance Fund (NHIF) to enhance the insurance cover. The government sponsored Managed Equipment Services (MES) is enhancing diagnostic and curative capacity at lower tiers of the health system, thus improving patient care and precluding unnecessary referrals.

Sounds like tremendous progress, but the number of newborns dying remains unacceptable. What more needs to be done to improve outcomes for premature and low birth weight babies?

Indeed, we’re making good progress in reducing child mortality as depicted by recent statistics. In my view, in spite of the attendant challenges, devolution has enabled faster progress in our effort to improve healthcare services. But the disparity in child mortality across counties reminds us of the need to address inequity by giving more attention to counties with the highest child deprivation. We need to do more in addressing health system bottlenecks such as infrastructure gaps, deficiencies in health worker numbers and skills, commodity security, and strategies to stimulate demand and utilization of services. The task at hand requires that stakeholders work better together, including tapping into opportunities for public-private-partnerships and innovation. I am convinced that by 2030 we can achieve our SDG goals and thereby help more premature babies to survive, thrive and transform.