By Joyce Ojanji
Prematurity is the leading cause of death in children under the age of five years in Kenya with approximately 134,000 babies born too soon annually. As such, the Ministry of Health (MoH) is strengthening health facilities across the country to provide comprehensive newborn care services including equipping newborn units and training healthcare workers in line with the universal health coverage (UHC) agenda.
Speaking to the media, ahead of the World Prematurity Day marked on 17th November, Janet Karimi, Head of Newborn and Child Health, Ministry of Health Kenya, noted that having a baby born too soon could result in severe financial burden for many families, communities and overall health care system and therefore World Prematurity Day is an important day that galvanizes stakeholders support in giving premature babies the best chance to survive and thrive.
“As a country, if we can avoid deaths of newborns, then we can increase life expectancy and this is through enhanced interventions for preventing and treating prematurity through promotive and preventive care, care of complications and family involvement and supportive routine care,’’ she said.
Karimi said for prevention and treatment of prematurity, MoH is intervening through equitable access to high-quality sexual and reproductive health services, including family planning and empowerment of women, enhanced quality of ante-natal care packages for all women, including screening for sexually transmitted infections (STIs) as well as timely diagnosis and treatment of STIs, high blood pressure and diabetes.
She observed that the ministry and its partners will be rolling out guidelines on the management of Apnoea (Absence of breathing for a period of >15 seconds) of prematurity on World Prematurity Day.
Although in approximately half of the preterm births, the cause is unknown and can happen to anyone, Mary Waiyego, neonatologist noted that maternal complications are the major causes of the preterm births.
These include infections such as urinary tract and amniotic membrane infections, uterine malformations, poor nutrition before and during pregnancy, history of birth to a premature in a previous pregnancy and smoking and alcohol.
She said that prematurity is determined by an ultrasound, a scan done on the pregnant lady and it needs to be done early enough before 20 weeks or the date of the last menstruation period, for it to be accurate. In the case a person is suspected to have a preterm birth, then it should be in a facility with good infrastructure, trained personnel and an environment that can increase the baby’s chances of survival.
Once the baby is born, to ensure its chances of survival, she emphasized, proper feeding through breast milk, hygiene maintenance, early identification and treatment of infections with antibiotics, ensuring proper care and support for breathing, including the use of Continuous Positive Airway Pressure (CPAP), caffeine citrate, provision of oxygen where needed, frequent monitoring of the baby’s vital signs, for example, oxygen saturation, temperature, respiratory rate and pulse rate and blood transfusion as needed.
“We believe that nutrition is an entry point to prevent prematurity. As a country, if we manage to fight the burden of malnutrition, then we will be able to save a lot of expenses that come with premature births. This is because diseases caused by poor nutrition habits such as diabetes are the major key factors leading to premature births globally,” said Stephen Mwangi, Programme Manager at Nutritional International.
He said that as an organization they work as an implementing partner with the MoH to facilitate county training on educating people on the risks of premature births and also training healthcare givers on how to handle preterm births in the facilities.
They also advocate for a county management team to dedicate space and then see what low-cost equipment they can be able to mobilize from their end and in case there are those ones that need to be procured, then that’s where they come in and support.
According to Kenya Health Information System (KHIS) 2, 2023, the proportion of neonatal deaths due to prematurity has steadily increased in 2023 compared to the previous years in Kenya.