Neonatal health - what’s the big deal?
Since 2014, Kenya has made huge strides in reducing its Infant Mortality Rate (defined as 0-12 months), but when we take a closer look at the statistics it’s clear that neonatal mortality rates (covering the first 28 days of life) have remained relatively stagnant. 56% of infant mortality occurs within the neonatal period. Sadly, babies are still dying in their first weeks of life.
We want to focus on this period and determine what kind of contribution we can make to improve these statistics in years to come.
Postnatal care and why it matters
Kenya has invested heavily in championing antenatal care and encouraging expectant mothers to attend the recommended 4 antenatal care appointments (following WHO guidelines); similarly we’ve seen huge increases in the number of women delivering their babies in hospital - making giving birth safer for both mum and baby and identifying key danger signs early so they can be monitored/managed.
The postnatal period, in contrast, has been somewhat neglected. 53% of women in Kenya do not receive any postnatal care, and only one fifth make it to the 6-week post-delivery mark. For many mums the concept of postnatal care is limited to immunisations and family planning, despite extensive guidelines within the Kenyan health care system for what mums can and should receive in terms of care for themselves and their baby.
We know that this lack of attention towards postnatal care is impacting neonatal health. It is during the postnatal period that we are able to identify some of the causes of neonatal mortality and work to prevent them.
Following our research in Kwale County, where we are delivering our latest baby box project, we learnt from the Director of Reproductive Health Services that while 75% of women in the region were delivering their babies in hospital only 25% of women in the region were attending postnatal care. What's more, the majority of the 25% were women who had delivered at home and thus were seeking post-delivery support. The link between hospital deliveries and postnatal care is broken.
However, the barriers to accessing and providing postnatal care are not insurmountable:
- We need to empower mums so that they know what postnatal care they are entitled to, and how to ask for it.
- We need to make sure healthcare workers are aware of and are using existing postnatal care guidelines (which are comprehensive but underused) and the standard postnatal care package.
- We need to improve the quality of care for mums and babies when they attend postnatal care working with facilities to advocate for the importance of this service.
At Child.org, we're working in collaboration with local health systems to ensure that the provision of quality postnatal care is a top priority.
Your Newborn: Essential Health SMS - harnessing SMS platforms to reach more mums
During the height of the Covid-19 pandemic last year we worked with MamaTips, an SMS-based service providing expectant mothers with antenatal care information. During this period many mums were hesitant to attend antenatal care appointments and the SMS service helped bridge the information/care gap. The feedback we received was incredibly positive but the question of ‘what next?’ remained. At the time, many organisations focused on innovative interventions during pregnancy but none focused on post-delivery assistance, a key period when women need both emotional support, information and care (e.g. for topics such as newborn nutrition).
This is why we launched our ‘Your Newborn: Essential Health SMS’ appeal. We want to provide a free, 2-way SMS service for mums to receive vital information and ask questions during the postnatal period, and encourage women to seek postnatal care.
There are particular benefits to using an SMS service, beyond just accessibility and reach. Our experience with MamaTips has shown that many women feel the SMS service is a safe space to ask personal or private questions that they may not feel comfortable asking in a clinic (questions about sex during pregnancy, or about sexually transmitted infections, for example) - with the SMS platform they can ask them without fear of judgement.
At the same time, while the SMS service will hopefully increase demand for postnatal care, we want to make sure that the quality of care women receive when they attend postnatal care improves, which is why a large proportion of the project will also focus on training health workers on postnatal care guidelines.
Plans for the SMS project are well underway, and we’re excited to share further updates with you during the appeal and when the project launches next year. In the meantime, if you feel inspired by what you’ve read above can we gently encourage you to support Your Newborn with a donation?
- £30 can arm 5 mums with life-saving information for their babies through the Your Newborn SMS bundle
- £100 can connect more mums with critical health services by training community health workers on referral tools.
- £500 can improve the quality of care for mums and babies by providing training for community health workers on national postnatal care guidelines
*yes, I’m talking about Ride Africa (come and join us in November 2022!)