Data from the national health registry shows there was a decline in pregnant women seeking antenatal services, with notable drops between November and December in the last five years.
Save for 2021, January often records high first-time antenatal visits. Then there is a decline in February before the numbers pick up in March again. However, the District Health Information System's data show an increase in the new antenatal clients, from 119,741 in January 2016 to 146,090 in 2021.
Dr Agatha Olago, Ministry of Health’s head of Family Health, noted a 23 per cent drop in antenatal visits in April last year, followed by a consistent recovery.
She said the ministry could not attribute this to Covid-19 alone. Dr Olago said there are other reasons, such as omission.
“Data from the Kenya Health Information System leaves out many teenagers who typically do not visit health facilities in their first pregnancy until after months,” she said.
Many expected a dramatic drop in 2020 due to the pandemic, but it followed the same pattern as 2016, 2017 and 2018.
The data may not raise anything alarming, but deaths occurred during the pandemic that more antenatal visits could have prevented.
The journal Lancet published modelling of 118 of the world’s countries in July 2020.
The study estimated that Covid-19 would cause the deaths of between 8.3 per cent and 38.6 per cent more pregnant women each month. The study raised the alarm that the numbers would be higher in countries with weaker health systems.
In Kenya, Covid-19 caused disruptions to essential health services, which means the numbers also represent women whose stories turned tragic. In Kilifi, a researcher has documented the effects of the pandemic.
While conducting his research Dr Stephen Okumu— a sociologist from Maseno University— has been interacting with traditional birth attendants (TBA). TBAs are older women trusted in their communities and often helped women deliver their babies without medical training. Since 2016, Dr Okumu had kept in touch with the women until July 2020, when he was investigating the impact of the Covid-19 restrictions on maternal and child health.
In a study published in Frontiers in Sociology journal in April this year, Dr Okumu detailed the experiences of some women who gave birth last year during the lockdown with the help of traditional midwives in Kilifi.
The descriptions from the TBAs are ghastly.
A traditional birth attendant said: “Some women had complications, and from my records, three babies died when I was trying to help the mothers deliver. They died because two women came late when the complication was too hard for me to handle, while one was a severe complication that I could not handle. I managed to remove the baby, but it was already dead.”
Although his study was primarily qualitative, it strongly suggests an increase in maternal and neonatal deaths during the Covid-19 pandemic lockdown in Kenya.
“This increase can be attributed to the effects of the pandemic, which have led to delays in accessing life-saving procedures such as caesareans, due to staff deployment and shortages, fear, and lack of infrastructure,” Dr Okumu said.
Many of the women he interviewed could access health facilities but refused to go there, fearing they could contract Covid-19.
Women who delivered with the help of traditional attendants are also not captured. So nobody knows if their number increased or not. In addition, some maternal and neonatal deaths may also not have been captured.
Edited by P.O and Verah Okeyo
The Hidden Killers 2.0 was supported by the Pulitzer Center.