Wellness & Fitness

Absence of data greatest obstacle in dealing with premature baby deaths

KID

Availability of records are key in tracking and helping curb pre-term baby deaths. PHOTO | FOTOSEARCH

Insufficient information is the greatest obstacle in stopping the deaths of premature babies. This was revealed organised by the pre-term birth initiative symposium held by the Aga Khan University Hospital recently in Nairobi.

Participants argued that without proper records on deaths of pre-term babies, it is impossible to determine the gravity of the issue and to device ways of dealing with it.

“Every birth and death of a pre-term baby should be counted to know how big the problem is. With precise data the sector will be well-informed and in a position to deal with the challenge.

“Better data monitoring and evaluation to save the lives of mothers and babies should be encouraged,” said Dr Hillary Kipruto, a specialist at the World Health Organisation (WHO).

In Kenya, pre-term babies dying after birth never receive birth or death certificate, which most parents do not consider important. Most pre-term babies are cremated in hospitals.

“I saw no point of going through the process; it would not bring our baby back. It would mean more pain for my family and I could not put them through that,” said a parent who lost his son born prematurely hours after birth.

Currently, the government has devised a way of ensuring that children are registered by directing schools to only enrol those with birth certificates in schools.

Health experts say when births and deaths are not all captured, initiatives aimed at curbing deaths of pre-term babies are not properly designed to deal with the full scale of the challenge.

Currently, the only figure available on the number of pre-term deaths in Kenya — 22 per 1000 births — is rather vague as details on how these babies were lost is unclear, further complicating campaigns geared towards stopping pre-term deaths.

“If we cannot count infant deaths then we cannot make any progress. Measurements and data use is the key to achieving success. If we knew what is driving the risk, then we can come up with preventive mechanisms and interventions,” said Dr Dilys Walker, principal investigator working with Preterm Birth Initiative East Africa.

About 15 million pre-term babies are born every year but 2.6 million die a few weeks after birth, with sub-Saharan Africa and Asia accounting to 78 per cent of the figure.

In Kenya, the common causes of pre-term deliveries are maternal conditions such as pre-eclampsia (pregnancy marked with high blood pressure), infections and ante-partum (before child-birth) haemorrhage; and some fetal conditions such as a pregnancy of more than one fetus and fetal distress.

High adolescent birth rate is a leading contributor to pre-term babies in Kenya and the free maternity has stretched healthcare services.

The rate of pregnancy among teenagers, defined by the WHO as persons between the ages of 13-19, in Kenya has doubled since 2009.

Latest data released by the African Institute for Development Policy shows that teenage pregnancy grew by 17 per cent to 37 per cent in 2014.

“There is burden of care at public hospitals because too many women are coming to access free maternity services,” said Health principal secretary Nicholas Muraguri.

Before introduction of free maternity, only 40 per cent of women gave birth in hospitals with the rest giving births at home but currently the figure stands at 70 per cent.

Health experts called on women to attend prenatal clinics at least four times during the pregnancy to lower the risk of having a pre-term babies.

The prenatal clinics ensure that women who are at risk are identified in advance and specific intervention put in place to deal with the complications if present or forthcoming.

“Screening and treatment of infections during the prenatal period such as syphilis, HIV, bacteriuria (presence of bacteria in the urine), malaria, bacterial vaginosis, tuberculosis and other infections thought to be causative of preterm births can also be done,” said Joseph Musana, a consultant obstetrician and gynaecologist at Aga Khan University Hospital.

Doctors are also able to tell when an expectant mother suffers from malnutrition during the clinics and preventive measures such as nutritional counselling and supplementation are put in place.

Pregnant mothers are also taught to be on the watch-out for early signs of labour during the clinics.

“Both obesity and underweight during pregnancy have been linked to preterm births and other adverse birth outcomes. Prenatal care offers the opportunity to counsel women on how best to prepare for the birth process,” he said.