The Directorate of Reproductive Health continued extending outreach support services to county health facilities despite challenges brought about by COVID-19 pandemic. Social distancing issues and travel restrictions made us retreat to the drawing board formulating narrow field delegation teams that ensured preservation of quality standards of our program. Convenience played a key role in selecting adjacent facilities majorly to avoid distant travel.
The team also worked with the neonatology team drawn from the Directorate of Paediatrics and Child Health. Senior Resident Doctors from Moi University Department of Reproductive Health also participated.
Goals of our visits were:
- Case by case Identification of management/treatment gaps of referred patients and formulation of corrective measures.
- Sensitisation of early new-born care, resuscitation and neonatal transfer.
- Sensitisation of the MTRH Referral policy.
- Sensitisation of specialist and subspecialist services available at MTRH.
- Sensitisation of short-term mentorship programmes available at MTRH.
We visited the following Hospitals:
- February 2021 – Huruma County Hospital – Uasin Gishu County
- February 2021 – Ziwa County Hospital – Uasin Gishu County
- June 2021 – Kapsowar Mission Hospital – Elgeyo Marakwet County
- June 2021 – Iten County Referral Hospital – Elgeyo Marakwet County
- June 2021 – Lumakanda Sub-County Hospital – Kakamega County
- June 2021 – Turbo Sub-County Hospital – Uasin Gishu County
Huruma Sub-County Hospital & Ziwa Sub-County Hospital
Both facilities being Level 4 Hospitals heavily referred patients to MTRH for Caesarean Section surgery. They also lacked presence of routine Consultant Obstetrician Gynaecologist services to see patients in their high-risk antenatal and Gynaecology outpatient clinic.
Our visits and advocacy paid off since the County Government of Uasin Gishu posted Gynaecologists there to run specialised clinics on a weekly basis. Theatre construction in both facilities is almost complete. We expect operations to be conducted there in the financial year of 2021/2022. This will help decongest our maternity wards and allow space for treatment of patients with complications requiring attention.
At Huruma County Hospital – Dr. Nyongesa Paul, Senior Lecturer from Moi university Department of Reproductive Health, addressing staff.
At Huruma County Hospital – Dr. Ben Locho Jumba, Gynaecologist MTRH making his remarks.
Kapsowar Mision Hospital and Iten County Referral Hospital
Both Hospitals offer referral and training services. Availability of curative services in both facilities has greatly increased over the last few years resulting in reduced referral of patients to MTRH. Iten Hospital hosts a Kenya Medical Training College (KMTC) campus and is also a national accredited training centre for Medical Officer Interns. Kapsowar Mission Hospital offers a comprehensive training base for Family Medicine Resident Doctors from Kabarak University and also hosts the Kapsowar Nursing School.
Our emphasis in both Hospitals was strengthening the MTRH Referral policy and sensitisation of neonatal transfer process due to unavailability of well-equipped and staffed new-born care units. We also highlighted need for prompt communication and referral for patients who required specialised care services e.g. ICU and Oncology care.
At Kapsowar Mission Hospital – Our joint delegation from Reproductive Health and Paediatrics and Child Health with Medical Director of Kapsowar Mission Hospital, Dr. Stanley Mutwol – 2nd (left).
At Kapsowar Mission Hospital – Dr Esther Wanjama and Nurse Esther Maina demonstrating neonatal resuscitation and transfer technique.
At Iten County Referral Hospital – Dr Esther Wanjama makes her presentation to doctors, nurses and other staff on neonatal Hospital transfer.
Lumakanda Subcounty Hospital and Turbo Subcounty Hospital
The main challenge involving both facilities was frequent theatre breakdowns and unavailability of proper new-born care units. Our visit has already spurred activity on the ground. The theatres are expected to be fully operational in July 2021.
At Lumakanda Subcounty Hospital – Dr Phillipe Poli, Gynaecologist at MTRH assesses labour delivery ward.
At Lumakanda Subcounty Hospital – Operating theatres. Main challenge is frequent electricity disconnections and irregular supply of anaesthetic drugs.
At Turbo Subcounty Hospital – Nurse Joyce Kenduiywo makes her presentation on early new-born care and transfer.
This remains our major objective as a way of contributing towards attainment of Universal Health Coverage (UHC). We are committed to continuously share our resources, both infrastructural and staff to all the counties within our jurisdiction with the sole aim being reduction of maternal and neonatal morbidity and mortality.
In the Financial Year 2021/2022, the Directorate intends to implement various strategies including: –
- Routinely sending out outreach teams on quarterly basis to monitor state of referrals and other emerging issues.
- Increased use of telemedicine conference facilities to discuss patients between facilities, capacity build and utilisation of learning resources.
- Active participation in the Counties stakeholders’ forums to provide real time feedback to county health managers and planners.
- Offering short-term mentorship training opportunities to county staff e.g., advanced labour monitoring, new-born care and resuscitation, cervical cancer screening etc.