Sasha is 22-years-old. She was married off when she was just nine and by the time she was 11, she was pregnant with her first child, and unprepared for childbirth.
So when labor came, in the middle of the night – in her geographically isolated village in rural Kenya – she was unaware of the painful fate awaiting her.
During childbirth, the baby’s head was too big to fit through Sasha’s pelvis, causing the baby to get stuck in her birthing canal. Traditional birth attendants tried their best to help Sasha but they were not skilled enough to handle the complications. She needed surgery, and quickly. But because she could not access emergency obstetric services, she spent the next six days trying to push out the baby that was stuck inside of her.
In the end, Sasha delivered a dead, rotten baby in macerated form. She was not only in grief of her lost child, but was also traumatized by her experience which left her with profound injuries and a double obstetric vaginal fistula.
About 21 pregnant women die every day in Kenya due to complications from childbirth. That’s equivalent to two 10-seater commuter micro minibuses, known as matatus, crashing every day with the loss of all the passengers on board.
Pregnant women in Kenya die because they either do not receive appropriate care during pregnancy or are unable to deliver with the help of skilled health attendants.
Mother’s milk has an enormous impact on child survival. While in Kenya it has improved over the past decade, the number of children who die before five years remains significant. The rate has decreased from 115 per 1000 live births in 2003 to 52 in 2014.
Neighbors Rwanda (2008), Tanzania (2012) and Uganda (2011) have recorded 50, 66 and 65 deaths per 1,000 live births for children below five years, respectively.
The main causes of childhood deaths are infections, preterm births and lack of sufficient oxygen, or asphyxia.
Breastfeeding infants on breast milk alone until they are six months old has been shown to reduce child mortality. When mothers can’t provide their own milk, the next best alternative is donor milk from other women. Access to “human milk banks” gives vulnerable infants, without access to their mother’s own milk, a healthy start to life.
The milk bank concept was initiated in Vienna in 1909 and was preceded by a century old practice of wet nursing – a mother breastfeeding another mother’s child.
Since then, over 500 human milk banks have been established in more than 37 countries globally in developed and developing countries. The pioneer countries include Brazil, South Africa, India, Canada, Japan and France.
There’s a growing global recognition of proper infant nutrition in the child’s first 1000 days of life. This can be monitored through encouraging proper nutrition during pregnancy and the first two years of life for optimal growth, health and survival.
Poor breastfeeding and complementary feeding practices are some of the common causes of malnutrition in the first two years of life. Breastfeeding confers both short-term and long-term benefits to the child like reducing the risk of infections and diseases like asthma, obesity, and type 2 diabetes. Mothers who breastfeed also lower their risk of developing breast and ovarian cancer, weak bones, obesity and heart diseases.
For countries to reap the benefits of breastfeeding they need to achieve a baby friendly status. Kenya began promoting the baby friendly hospital initiative approach in 2002. It ensures that health facilities where mothers give birth encourage immediate initiation of breastfeeding and exclusive breastfeeding for the first six months. Unfortunately, this programme was only accessible to women who delivered in the health facilities, leaving out those who give birth at home.
We conducted a two year study involving 800 pregnant women and their respective children in a rural area in Kenya. The study involved testing feasibility and potential effectiveness of the baby friendly community initiative (BFCI), whereby women in the intervention arm were given home-based counselling on optimal breastfeeding alongside health facility based counselling. These mother-child pairs were followed until the child was at least six months.