In many parts of Kenya, by the time a woman in labor arrives at a hospital, she and her baby are often already in trouble. There are many factors that can contribute to this situation – cultural and family pressures to give birth at home, lack of understanding about the telltale signs that labor is taking a turn for the worse, or a long journey to a clinic that puts additional hardship on a woman’s body and on her baby. Many times, even the fare to pay for the bus or taxi ride to the hospital is not available! Once at the hospital, what happens in the first moments after birth can quickly make the difference between life and death.
One in 10 newborns globally will experience birth asphyxia, or difficulty breathing at birth, and prolonged obstructed labor is a significant cause. Interventions to save a baby’s life can be as simple as warming the baby and rubbing its back or feet to stimulate it to breathe. But skilled birth attendants are present at only 44 percent of births in Kenya, and training for the skills to revive a newborn has not been widely available – even to health care workers in the very hospitals where women turn for help.
Just last week I met with health workers from remote rural mission hospitals in Kenya who have experienced how important those first moments after birth are – and how terrible the silence is when a newborn does not draw breath and begin to cry. They lament that nurses posted to rural hospitals are often newly trained and have not yet learned the skills needed to intervene. In an emergency where the mother’s life is at risk, there isn’t always time to find someone who knows how to help the baby breathe. With no intervention, one in 10 of those infants will die. A few miles from my village home is a small rural clinic where pregnant women from my village will visit at the onset of labor. It would be most reassuring to know that the health workers at such a clinic would have the requisite skills that could lead to better outcomes. These skilled workers could dramatically reduce infant mortality for attended births in the country.
Next month Helping Babies Breathe, a program designed and led by the American Academy of Pediatrics (AAP), will make an exploratory venture to scale up in Kenya and put these practical, simple skills into the hands of health workers across the country. AAP, in partnership with Johnson & Johnson, has identified a team of health care leaders from the Ministry of Health and major Kenyan health associations to begin a conversation about how to improve education and stop birth asphyxia in Kenya. Together, these stakeholders will discuss plans for bringing neonatal resuscitation into mainstream medical training.
The first meeting of this group will take place the same week that Mother’s Day is celebrated in many countries – I can think of no more fitting of a Mother’s Day gift for a new mother than a chance to hear her baby breathe. We look forward with great anticipation as we bring these partners together.
Rene Kiamba is Manager of Corporate Contributions, Johnson & Johnson, Nairobi, Kenya