The healthcare system and client failures contributing to maternal mortality in rural Kenya

Background The global maternal mortality ratio is estimated at 211/100 000 live births in 2017. In Kenya, progress on reducing maternal mortality appears to be slow and persistently higher than the global average, despite efforts by the government’s provision of free maternity services in both private and public facilities in 2013. We aimed to explore and describe the experiences of midwives on maternal deaths that are associated with the healthcare system and client failures in Migori, Kenya. Methods An explanatory, qualitative approach method was adopted. In-depth interviews were conducted with the purposively selected midwives working in peripartum units of the three sampled hospitals within Migori County in Kenya. The hospitals included two county referral hospitals and one private referral hospital. Saturation was reached with 37 respondents. NVivo 11 software was used for analysis. Content analysis using a qualitative approach was adopted. Accordingly, the data transcripts were synthesised, coded and organised into thematic domains. Results Identified sub-themes: sub-optimal care, staff inadequacy, theatre delays, lack of blood and essential drugs, non-adherence to protocols, staff shortage, inadequate equipment and supplies, unavailable ICU wards, clients’ ANC non-adherence. Conclusion In conclusion, the study notes that the healthcare system and client failures are contributing to maternal mortality in the study setting. The major failures are across the pregnancy continuum starting from antenatal care, and intrapartum to post-natal care. This can illustrate that some pregnant mothers are getting sub-optimal care reducing their survival chances. To reduce maternal mortality in Migori County, the key highlighted healthcare system and client failures should be addressed through a multidisciplinary approach mechanism.Health Studie

Drivers of early marriage and teenage pregnancy in Kenya and Uganda during COVID-19 lockdown period: A systematic review

The present study aimed to explore the drivers of early marriage and teenage pregnancy in Kenya and Uganda during COVID-19 lockdown period. A systematic review design was adopted. The major online databases utilized were PubMed, Google Scholar, Uganda and Kenya Ministry of Health repositories, ScienceDirect, and Scopus. Studies that were originating from Kenya and Uganda that were publicly available in electronic format published from March 2020 to March 2022 were used. The thematic analysis identified major concepts that were drivers to the present research problem which were as follows: (1) school closure and (2) loss of income by parents. The COVID-19 containment measures introduced in the two countries were noted as major contributing factors. During the pandemic, lockdown led to school closures which meant the teenagers being idle at home with an increased opportunity to indulge in sexual risk behaviors. Schools have been noted to be a safe place protecting this vulnerable population. However, with their prolonged closure, the teenagers were exposed to sexual predators. Parents lost income, and this might have contributed to early marriages and teenagers' dependency on their sexual partners. Based on the reviewed evidence, the present study furthers the advocacy for the reduction of early marriages and teenage pregnancy, especially in the current COVID-19 pandemic era. The study calls upon the governments to intensify efforts toward the present research problem as the COVID-19 pandemic is eroding the earlier gains made within the regionHealth Studie