SEATTLE, Washington — According to the United Nations, Kenya is among the 21 countries with the highest ratio of maternal deaths. During the pandemic, home births have become much more common as the number of hospital visits has declined by nearly 25%. In turn, maternal and child health markers such as prenatal care visits and hospital deliveries are decreasing and thus escalating risks for pregnant women. There has been a stark increase in the number of stillbirths recorded amid the pandemic. In March 2020 alone, there were 1,330 stillbirths, reversing the gains made in lowering maternal and infant mortality and morbidity in the region. Wheels for Life is an initiative to assist expectant mothers in Kenya during COVID-19.
The Issue: Maternal Health Struggles
Many expectant mothers in Kenya have no other alternative but to either deliver at home or walk to the nearest health facility due to the unavailability of public transport and travel restrictions. The World Health Organization (WHO) and Kenya Obstetric Guidelines encourage delivery at healthcare facilities to significantly reduce maternal and neonatal morbidity and mortality. According to UNICEF, in 2017, Kenya had a high maternal mortality rate (MMR) of between 300 to 499, which is far higher than the sustainable development goal that aims at reducing MMR to less than 70.
As the COVID-19 pandemic has threatened Africa, Kenya was one of the first countries to promptly and decisively respond. It put a partial lockdown in place, closed schools and businesses, restricted travel, movements and gatherings. The Government of Kenya has instituted a curfew from 7 p.m. to 5 a.m. to curtail the spread of COVID-19. The pandemic has disrupted essential health services and coupled with the lockdowns, curfews and increased risk for contracting COVID-19, it has affected how women access health facilities. This travel ban has presented disastrous challenges for expectant mothers as they struggle to access emergency care, and has exacerbated already elevated maternal morbidity and mortality rates.
Additionally, it has become increasingly difficult to find trained, reliable and willing midwives and healthcare workers to break the curfew and aid in labor and delivery at night. When pregnancy complications arise, these mothers are often left stranded or are forced to travel on foot to the nearest healthcare facility.
The Solution: Wheels for Life
Launched in April 2020, the Wheels for Life project was created to respond and help women in labor present with obstetric emergencies during curfew hours. It is currently a program by the Ministry of Health, Nairobi Metropolitan Services, Kenya Healthcare Federation and SMREF Health Africa, along with a host of other organizations, collectively volunteering to provide easy access and triage process for pregnant women in emergencies. Women are able to speak with a doctor through a toll-free number and if necessary, obtain free emergency transport to a health facility for safe baby deliveries. This network is strengthening community-based care, creating a more resilient health system.
The Wheels for Life Initiative aims to ensure essential, WHO recommended maternal care and access to healthcare services. The overall goal is to end preventable maternal deaths during curfew and the COVID-19 pandemic in Kenya. The goal is to avail safe transport convenient to support 3,000 deliveries per month, and currently, the initiative is only operating within Nairobi County. As of July 2020, more than 12,000 calls have been made to doctors using the toll-free number. Additionally, 1,029 mothers have been assisted by doctors, 478 cabs have been dispatched, and the initiative has facilitated 143 emergency ambulance trips.
During an ongoing health crisis, transportation services are key to sustaining the health and well-being of pregnant women. There is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in an already strained health system.
“Saving a mother means saving a community and a nation”, states the Wheels for Life initiative. By creating a coalition of organizations to combine efforts, expectant mothers in Kenya are receiving the vital medical help they need.
– Samantha Johnson