In a move to prevent maternal deaths due to excessive bleeding, Makueni county is using calibrated drapes in public health facilities to manage childbirth complications.
The clear, paper-like sheets are placed on the bed during delivery. They provide a precise measurement of blood loss, enabling healthcare workers to detect and address postpartum hemorrhage (PPH), the leading cause of maternal death within 15 minutes.
Makueni was once among the top 10 counties with the highest maternal mortality rates in the country. But since 2022, Makueni has not recorded a single death from excessive bleeding in public health facilities, positioning the county as a trailblazer in maternal healthcare innovation.
The county has purchased 11,000 drapes. Dr Stephen Mwatha, the Makueni county’s director of preventive and promotive services said the drapes have been distributed to all hospitals.
“The plan is to ensure that excessive bleeding is detected early and managed to prevent complications that arise from blood loss,” he said.
PPH is responsible for two in five maternal deaths in Kenya, according to the Ministry of Health’s First Confidential Report on Maternal Deaths in Kenya.
Kenya followed the 2023 World Health Organization (WHO) recommendation from the E-Motive trail that involved 200,000 women in Kenya, Nigeria, South Africa and Tanzania.
Michael Mwiti, a midwifery and maternal health specialist at the Johns Hopkins affiliate, Jhpiego, said PPH kills women because it is detected late and or even misdiagnosed.
“Most healthcare providers check visually to assess bleeding, and that often tends to underestimate how much blood the mother has lost, and then treatment is delayed, leading to life-threatening consequences that could lead to the mother losing her uterus or dying,” he said.
The WHO-backed study conducted in 80 public hospitals in the four countries also showed that after the diagnosis, the healthcare provider offers all the treatments available within 15 minutes, and not one after another, as has been the practice.
When the treatment is bundled as opposed to offering them one after another, it reduces severe bleeding and death by 60 per cent.
Makueni is among the first counties to embrace the use of calibrated drapes and then giving treatment as a bundle.
The treatment includes massaging the uterus, giving uterotonics (medicines to contract the womb and stop the bleeding), giving the mother intravenous fluid and the healthcare examining the mother to see whether there is need for referral.
While the drapes are not as costly, changing the operations of a health system is far from affordable. It involves training healthcare workers in more than the 100 facilities in Makueni that offer childbirth.
Cash-strapped, the county worked with partners like Unitaid, which worked with the county through the project called Accelerating Measurable Progress and Leveraging Investments for Postpartum Haemorrhage Impact.
Mwiti, the project lead for AMPLI-PPHI said they trained 570 healthcare workers on all the aspects of the bundling method and tested how it works if integrated into the county’s health system.
“AMPLI-PPHI gave Makueni
medicines that can last three years,
supplied 36 training models for the
healthcare workers and talked with
the community through opinion
leaders like businesspeople county officials and community health
promoters to ensure everyone knows
the danger signs of pregnancy and
when to seek healthcare,” he said.
