Other innovative measures that are improving health outcomes, and which can be scaled to achieve UHC

Kangaroo care is a method recommended by WHO to save babies born before 37 weeks of pregnancy, extremely preterm babies born at less than 28 weeks and late preterm babies. UNICEF

Human milk bank

Every second around the world, a baby dies. In a year, about one million babies out of 15 million born prematurely, die. In Kenya, according to WHO, an estimated 196,000 babies are born prematurely, while eight percent are of low weight – less than 2.5 kilogrammes.

This is according to the Born Too Soon, The Global Action Report on Preterm Death by WHO, Save the Children, among others.

Breastfeeding is one sure way of saving infants’ lives.

Unfortunately, Kenya loses an estimated 20 women every day in childbirth, or 362 women for every 100,000 births. There are other reasons a baby may be denied the life-giving chance of breastfeeding. One, the mother may be sick, or has delayed lactation due to premature birth, or the baby has been abandoned.

WHO recommends breast milk as the first superior feeding option for all newborns.

Breastfeeding is the first preventive health measure available to a child at birth and also enhances mother-infant relationship. It is nature’s first form of immunisation, enabling infants to fight potentially serious infections. Breastmilk contains growth factors that enhances the maturation of an infant’s organ systems. For this reason, WHO recommends exclusive breastfeeding for the first six months. The health benefits of exclusive breastfeeding include protection from infection, allergies, some chronic diseases and childhood cancers, as well as sudden infant death syndrome.

So what happens if, for any reason, a baby cannot get breastmilk from the mother? Some people feed children with formula milk, which increases the risk of diarrhoea, bacterial infections and feeding intolerance.

In traditional societies, babies and children belonged to the community. In a case where a mother was unable to breastfeed or died soon after giving birth, a lactating mother in the community would step in and breastfeed the baby alongside hers. This is known as wet nursing.

This tradition has been borrowed by health workers in the form of human milk banks. Lactating mothers with excess breastmilk can donate the milk, which is screened, just like with blood donations. The milk is then pasteurised and stored for long periods of time.

The first milk bank is believed to have been established in 1909 by Theodor Escherich in Vienna. The following year, America got its first bank at the Boston Floating Hospital.

South Africa was for a long time the only country in Africa with a human milk bank (HMB), until Kenya, acclaimed as an early adopter in health innovations, opened its first HMB in 2019 at Pumwani Maternity Hospital, Nairobi. This was made possible through a partnership with PATH, Africa Population and Health Research Centre (APHRC) and the Ministry of Health.

In 2017, the consortium came up with national human milk banking guidelines.

The process of donating milk includes screening and recruiting healthy mothers with excess breast milk as donors. The screening involves testing for syphilis, HIV and Hepatitis B and C.

Donors express milk using either manual or electric pumps. The milk is then pasteurised – this involves heating the milk in a water bath at high temperatures followed by rapid cooling.

Thereafter, the milk is frozen and stored in the bank at -20 degrees[PW1] . The milk is availed to deserving children through prescription by a health professional.

The Pumwani HMB was opened in March 2019 and is already benefiting children who would have otherwise been fed on formula milk.

Kangaroo Mother Care

The lifesaving innovation of donating and pasteurising human breast milk is complemented by yet another crucial and lifesaving practice known as Kangaroo Mother Care (KMC). This practice is not driven by technology, but rather inspired by nature. KMC care is given to preterm infants through  skin-to-skin contact, usually by their mothers or any other member of the family. The infants are held by the caregivers chest-to-chest, much like the marsupial Kangaroo that carries its young in a natural  pouch.

KMC is used in areas without electricity or incubators. According to medics, KMC is better than incubators, as it provides a mother’s warmth, thus helping in the bonding between mother and child, as well as breastfeeding. Recommended by WHO, KMC was first tried in 1978 in the Instituto Materno Infantul Nicu in Bogota, Colombia, following high infant death rates in that country.

According to the International Federation for Gyneocology and Obstetrics (FIGO), 450,000 babies could be saved each year if KMC was provided to 95 percent of babies.

In Kenya, over 20 counties use KMC, including at hospitals like Pumwani and Kenyatta National Hospital.

At Pumwani, the KMC unit has 20 beds and is supported by Unicef and Save the Children. It is hailed by varoius partners as a success story, and is the reason Pumwani hospital was picked to pilot the milk bank project in the country.

The results of scaling human milk banking and KMC to all corners of the country is a no-brainer; it’s a cost-effective way to halt the needless death of infants while saving parents mental stress. It also saves money that can be used in treatment.

Digitisation of data in Kenya’s health facilities

Kenya enters its patients’ data daily on what is known as the District Health Information System (DHIS2). Besides recording, DHIS2 also validates, analyses and aggregates the data. It is basically the national ‘hive’ for data management and analysis, from monitoring health programmes to facility registries and logistics management. The data can be captured on desktops, laptops and smartphones, in addition to being available offline, hence ideal for rural areas.

Being digital, DHIS2 allows the collection and integration of data from various sources, which can be used in real time, from people in different locations. Health workers, the government and NGO users can  gain access to the system by signing up online with a username and password.

According to the developers, the DHIS2 platform is coordinated by the Health Information System Programme (HISP) at the Department of Informatics at the University of Oslo, which actively promotes DHIS2 as a global public good. The core aims of HISP are, through research and development, to strengthen national health information systems, enable countries master and manage their systems and wider health information architecture, and to provide countries with the capacity to carry this out. It also aims to improve local management of healthcare delivery and information flows, fostering collaboration and sharing best practices across developing countries.

Kenya is one of the over 70 countries that has adopted the use of the open source software. Other African countries include Tanzania, Uganda, Rwanda, Ghana and Liberia, as well as countries in Asia and Latin America.

Share this post

Comment on post

Your email address will not be published. Required fields are marked *