The World Health Organization (WHO) has issued new recommendations towards the establishment of global care standards for healthy pregnant women. Despite the global improvement in maternal health care, some countries are still struggling to meet the basic needs of women during childbirth.These recommendations could not have come at a better time.
Kenya’s current maternal health care status
Speaking at a webinar organised by the Aid and International Development Forum ahead of a major event on Aid and International Development in Africa, Dr. Lutomia Mangala, a Health Specialist on Maternal, Newborn and Child Health for UNICEF noted that despite a global improvement in maternal, neonatal and infant health, Sub Saharan Africa is still lagging behind. This, he explained, is as a result of lack of quality healthcare provision.
Assessing the quality of maternal health services in Kenyan facilities, Sharma and others (2017) revealed that the quality of maternal health care is low, especially for adequate antenatal and delivery care. At the county level, only 9% of the Kenyan population has effective antenatal care (ANC) coverage and only 17% have effective delivery care coverage.
The case is grimmer for poorer women. According to the report, “on average, women living in the most impoverished areas of Kenya received one-third of basic clinical ANC compared to wealthier women, who received roughly 60%.”
It is for this reason that the WHO through it’s Assistant Director-General for General Family, Women, Children and Adolescents, Dr Princess Nothemba Simelela, has committed itself to ensuring that women “…give birth in a safe environment with skilled birth attendants in well-equipped facilities.
We want women to give birth in a safe environment with skilled birth attendants in well-equipped facilities. -Dr. Simelela
New WHO recommendations for supportive maternal care
The new WHO guideline includes 56 evidence-based recommendations (PDF) on the type of care needed throughout labour and immediately after for the woman and her baby. These include;
- Having a companion of choice during labour and childbirth
- Ensuring respectful care and good communication between women and health providers
- Maintaining privacy and confidentiality
- Allowing women to make decisions about their pain management, labour and birth positions and natural urge to push, among others.
1. Every labour is unique and progresses at different rates
The guideline recognizes that every labour and childbirth is unique and that the duration of the active first stage of labour varies from one woman to another.
According to the guideline, to reduce unnecessary medical interventions, the previous benchmark for cervical dilation rate at 1 cm/hr during the active first stage of labour may be unrealistic for some women and is therefore inaccurate in identifying women at risk of adverse birth outcomes.
It further emphasizes that slower cervical dilation rate alone should not be used as a routine indication for intervention to accelerate labour or expedite birth.
2. High-quality care for all women
Disrespectful and non-dignified care is prevalent in many health facilities, violating human rights and preventing women from accessing care services during childbirth. Thus, to prevent deaths from childbirth-related complications, high-quality care in pregnancy and during childbirth should be given.
3. Health care systems that empower women
Extra care and effort should be administered to expectant mothers to give them the necessary physical, emotional, and psychological outcomes. Health care systems should, therefore, design models of care that focus on empowering women to access care that benefits both the mother and child.