Center for Public Health and Development

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Portfolio Title: CEmONC

Grant Type: Innovation

Counties: Turkana

Timeline: July 2017 - March 2019

Funding Round: 3

The Problem

Turkana is a vast county with immense challenges in providing health care services, with the third highest maternal mortality rates of Kenya’s 47 counties1. One of the major contributing factors is poor access to health facilities that can provide Comprehensive Emergency Obstetric and Newborn care (CEmONC). It has three facilities that provide these services, forcing mothers to travel more than 200 kilometres, on rough terrain when complications arise. Poor access to electricity also contributes to a low caesarean section rate of about 3.6%, far below the World Health Organisation’s recommended 10%2. Currently, the county has only one specialist obstetrician who is based at the Lodwar County Referral Hospital. Medical officers deployed in health facilities where CEmONC services are not on offer (due to lack of electricity and equipment) risk losing related skills such as proficiency in conducting C-sections.

Innovation Solution: Solar-Powered CEmONC Centres

Turkana County, like other arid and semi-arid areas, have plenty of sunshine throughout the year providing a great potential for tapping solar energy to power equipments for CEmONC services. CPHD is piloting an innovation where the green energy will be used to power two CEmONC centres at Lorugum and Katilu Sub-County hospitals. The technology includes installation and use of a solar-powered Universal Anaesthesia Machine (UAM), that integrates an anaesthesia machine with a ventilator, patient monitor, and oxygen concentrator. The UAM has low power consumption, does not require piped or cylinder oxygen, and has internal batteries that can run it for up to 6 hours without power. To bridge the gap of low numbers of anaesthetists in Turkana, the project will train nurses on theatre nursing and anaesthesia in collaboration with Kenya Medical Training College.  In addition, the project will develop and utilize an  interactive m-health solution that will digitize the WHO Surgical Safety Checklist modified for C-section. This application will  provide decision support to clinicians, and also provide vital surgical data that can be used for quality assurance.

Expected Results

The project aims is to improve access to CEmONC services, increase C-section rates, and improve C-section outcomes in Turkana county. It will also investigate whether appropriate technology such as UAM and green energy innovations can cost effectively improve physical access CEmONC services in remote settings not served with mainstream electricity grid.

Progress as of August 2018

  • Physical infrastructure at Loima and Katilu Sub-County Hospitals refurbushed to accommodate surgical theatres and wards.
  • Solar power systems installed at both hospitals.
  • The UAM and other essential theatre equipment procured.WHO Surgical Safety Checlist digitised and availed on Android mobile operating system.
  • Selected health care providers sponsored to attend attachment at Kisumu County Hospital for mentorship and skills building on CEmONC.

For more information about this project, contact:

Dr. James Wariero

Center of Public Health and Development

Kimani Karuga

Options Consultancy Services Ltd.

1 Counties with the Highest Burden of Maternal Mortality.

2 WHO Statement on C-Section Rates 2016.