In Kenya, an estimated 50,000 infants die before reaching their first birthday, with many of these deaths occurring in babies born prematurely or with a low birth-weight. These newborns are particularly vulnerable to preventable illnesses, but certain techniques and initiatives have been proven to significantly reduce mortality rates. The Options-led County Innovation Challenge Fund (CICF) has been supporting some of these novel interventions in Kenya to drive down death rates and give low-weight or premature infants the care they need to survive and thrive.
One such intervention is Kangaroo Mother Care (KMC). KMC refers to the practice of providing continuous skin-to-skin contact between mother and baby, coupled with exclusive breastfeeding. KMC has been shown to decrease mortality in preterm and low birthweight infants by providing protection from infection, regulating temperature, stimulating breathing and brain activity, and encouraging mother-baby bonding. Despite being a low-cost but highly effective intervention, uptake of KMC in Kenya has been low with only 55% of delivery facilities having space designated for this method of care. One reason for this was the lack of infrastructural support and training needed for national adoption of the method.
In Bungoma County in the west of Kenya, CICF is supporting Save the Children to roll out KMC in over 25 health facilities. Before this support, cases were reported of severely low-weight newborns being discharged from hospital. With a lack of resources to care for premature babies, infants weighing up to 700g below the internationally recommended birth weight, were being sent home without receiving the vital care they needed to survive.
To address this, KMC units were set up and 105 health workers underwent training and mentorship on the KMC technique. By the end of the pilot scheme, a total of 2,817 premature babies had been nursed with KMC and the neonatal mortality rate had dropped 6% at the facilities using KMC. The lessons from the Bungoma pilot informed the development of training materials, clinical guidelines and reporting tools and spurred momentum for national scaling up of KMC.
Another area of CICF-managed investment has been breastfeeding and the creation of a donated human milk bank in Kenya. Human milk has been proven to cut infant mortality, with estimates suggesting that over 823,000 children could be saved each year through near universal optimal breastfeeding practice. However, there are many cases where mothers are unable to breastfeed their newborns. In cases of maternal death, illness, or abandonment, vulnerable infants are currently left unable to access human milk.
This is expected to change by the end of the year, as Kenya hopes to open its first human milk bank. The project has taken inspiration from the success of the South African Breastmilk Reserve, which is in its 15th year and fed almost 3,000 infants in 2017. When the Kenyan bank opens, it will be only the second project of its kind on the continent, receiving surplus milk from mothers and distributing the donations to vulnerable infants.
CICF has already facilitated learning exchanges to South Africa and development of national human milk banking guidelines, standard operating procedures and quality control measures. More recently, training of healthcare workers and managers as well as awareness campaigns have commenced readiness for opening the bank.
Both human milk banks and an expansion of kangaroo mother care facilities are vital initiatives if Kenya is to reduce mortality rates of pre-term newborns. 193,000 babies are born prematurely in Kenya every year and 9,670 of them will not reach their fifth birthday, making these early care methods indispensable, to ensure low-weight infants can grow to reach their full potential.