One evening in July, 16-year-old Hildah went to the central hospital in Kitale province in western Kenya complaining of abdominal pain. Two hours later, she became a mother. Hildah's delivery was quick but trying. “I really suffered, and I was scared,” she recalls. Her baby was born breech, which made the delivery difficult.
In order to ensure a safe delivery, Hildah needed a surgical incision. She was scared, but the midwife, Floidah Otoli, explained why it was necessary and reassured Hildah about her health and that of her baby. The procedure went smoothly.
Two days later, back home with her son swaddled and sleeping peacefully in her arms, Hildah was grateful despite the postpartum discomfort.
“I was treated well in the hospital,” she says. “If I hadn't been there, the situation could have turned into a tragedy. The pain would have worsened, and I could have died.”
Through Action Against Hunger’s SETH (System Enhancement for Transformative Health) project, health professionals at the Kitale Province Central Hospital benefit from hands-on training, mentoring, and courses to improve the quality of maternal, neonatal, and infant health services.
The project can have lifelong benefits for children. Research shows a child’s first 1,000 days of life - between pregnancy and a child's second birthday – are a critical window of opportunity. Good nutrition and other key health services, like vaccinations, in this time period build a strong immune system, ensure healthy physical and intellectual development, and vastly improve a child's chances of survival.
Floridah was trained in the program, and her new skills and knowledge now benefit mothers like Hildah. In addition to receiving training on how to provide appropriate care for expectant mothers, Floridah learned how to monitor pregnant women with prenatal complications, manage preterm deliveries, measure dilation during childbirth, diagnose problems such as deep vein thrombosis, and perform physical exams to assess the health of mothers and their babies after childbirth.
“I feel like I am better prepared because I now have the skills to spot what is wrong,” says Floridah. “When I identify an issue that has been overlooked, I can manage or assign it appropriately.”
As she cared for Hildah and her child, Floridah also helped the young new mom learn how to take care of her baby, showing her how to breastfeed and swaddle the little one in linen to ensure safer and better sleep. Floridah asked Hildah to come back to the hospital with her son for follow-up appointments two and six weeks after the birth for pediatric exams and vaccinations to ensure that mother and child continue to be healthy.
“I think the advice the nurse gave me will help me take care of the baby,” Hildah says. A soft-spoken young woman who is a single parent with little support, Hildah lives with her older sister in a simple, two-room house. Her sister provides moral support, but has no experience in raising children, so the compassionate, attentive care and confident guidance Hildah received from Floridah and other staff at the hospital have been a lifeline.
The SETH project - which is implemented by Action Against Hunger and Helen Keller International with financial support from Global Affairs Canada - aims to strengthen the health system and improve maternal and child health outcomes in Kenya. The project has trained more than 800 health workers in five provinces of Kenya to improve the quality of care, which led to an increase in the number of women seeking services.
In fact, the number of pregnant women in Hildah’s region who received at least four antenatal consultations increased from 37% to 43% between 2016 and 2018. During this same period, the number of women giving birth assisted by skilled personnel increased by 4%, and the number of women who received postnatal care increased from 5 to 33%.
At the Referral Hospital in Kitale Province, Floridah reports that staff can treat 30 pregnant women with standard deliveries and perform up to ten cesarean sections per day. It's a lot of work for a small hospital, but Floridah says that with the support of the SETH project, they can provide their patients with the care they need. The benefits of the project continue to reverberate throughout the community.
“I feel more empowered. I'm in a better position to provide services, so that in the end we have a healthy mother and baby. And if we do that, we also have a healthy nation," says Floridah.