Mandera County covers 25,991 square kilometres with a total population of 1,025,756, according to the Kenya National Bureau of Statistics (KNBS).
According to the county’s health department, the number of primary health care facilities (health centres and dispensaries) has increased from 18 to 68, while 25 new housing units for health workers have been constructed to accommodate health workers in remote areas.
Afyasmile Kenya visited Burduras Health Centre and had a chat with the nursing officer in charge, Siyat Hussein, who has been at the Centre.
The Burduras six-bed maternity wing is among the 18 additional modern maternity wings which have been constructed by the county government in Burduras sub-location, Mandera West constituency, to increase access to skilled delivery and quality health services.
“Burduras Health Centre began its operation in October 2010 and services offered include outpatient services, immunization, antenatal and postnatal clinic,” Mr. Siyat Hussein, a nursing officer in charge told AfyaSmile.
Other services offered at the new facility include nutrition, health education, maternity, family planning, growth monitoring and HIV counselling and testing.
A national report shows the HIV prevalence in the County has been on the increase from 1.7 per cent in 2007 to 2.1 per cent in 2014.
The county has more than 3385 People Living with HIV (PLHIV) with approximately 121 new HIV infections annually.
Mr. Siyat says that the rural health centre attracts 300 to 400 outpatients monthly, and the majority of the number are adults particularly women.
The number of deliveries at the Health Centre has been on the rise which could be attributed to the increased number of community health workers, the mobilization of women to give birth in the health facility by trained community health workers.
“When it comes to delivery, we have home-based delivery, where well-trained traditional birth attendants help mothers in their homes for safe maternal care.
The TBAs have been put under seminars by Save The Children and they are well trained in matters pertaining to delivery services,” Mr. Siyat reveals.
New model adopted
According to the model adopted by the facility, community health workers ensure expectant mothers come to the health facility. They provide maternal reports to the Health Centre and do deliveries at homes.
Mr. Siyat says that Save The Children has since stopped the training.
However, all is not lost for the Health Centre as they try to build on capacity and promote healthy living among communities in the North-Eastern county.
Once the new maternity wing is operationalized services will be improved significantly.
“We register and attend to women who give birth at home with the watch of qualified and trained birth attendants.
In the elapsed 4 months period of January to April, a total of 130 has been registered (January 36, February 31, March 36, April 27 respectively),” Mr. Siyat says of the maternal achievement.
The county’s maternal mortality ratio stands at 3,795/100,000 live births, about eight times higher than the national average (360/100,000 live births) while the neonatal mortality rate and under-five mortality are 72 and 80 per 1000 live births respectively, according to a report from the county’s health department on reproductive health.
Challenges in service delivery
Located near the Ethiopian border, some of the challenges faced by the health workers at the Centre include poor network connection, understaffing and poor infrastructure limiting accessibility.
The hospital staff says that as a result of poor connectivity, they miss out on important things such as seminars and training.
“Sometimes I’m required to attend a certain seminar and since we don’t have the network in the area, I miss the invitations and even worse, fail to make it to the events,” says Mr. Siyat.
The facility is also faced with an acute staff shortage. For example, currently, they are looking for a nutritionist.
As soon as the new maternity wing will be ready, they will require more skilled staff to address the shortage.
Impassable roads have made it difficult for the local and the neighbouring communities to access the crucial services offered at the facility.
Ibrahim Adan Hussein, a patient from the who visited the dispensary for injection and intravenous fluids after suffering from a hand-muscle sprain, notes that the facility has brought life to a once-neglected area.
Free service offered
“I came here a few days ago and received an injection after my arm muscle strained. Although I don’t visit the Centre frequently, the services offered to come as a great relief for the community now that most are free,” he says.
Khadija, a resident believes that operationalizing the new maternity wing and increasing the number of health workers will boost health service provision in the area.
“We hope the county government will operationalize the new maternity wing as fast as possible so that we get more services at the Centre.
Delivery-related complications were greatly reduced since traditional birth attendants and community health volunteers were offered good training.
As we speak now, the Health Centre can easily be accessed at any given time”, she adds.