The failure to deliver quality childbirth care in Kenyan health facilities

In Kenya, many women would rather deliver their babies at home, with no assistance, no drugs, and no medical equipment, than step foot inside a public or private hospital.

These same women would decide not to seek reproductive health care services, thereby increasing their risk of complications during childbirth and creating a higher maternal mortality and child death rate in the country.

The reason for this attitude among women is not ignorance, lack of information, or traditional values—it is the range of gross human rights violation occurring in Kenyan hospitals and clinics.

Over the years women have reported multiple cases of abuse during delivery, including being called ‘stupid’ by nurses; being cut with scissors to make delivery easier for nurses; being left alone to deliver; being forced to lay on soiled sheets during delivery; not receiving food or water during and after childbirth; having to wait an excessive amount of time for stitching vaginal tears; and being stitched with little or no anesthesia.

One woman working in a delivery ward in Kisumu, Kenya, reported that nurses often cut patients’ vaginas on purpose with scissors so that they could then make money for stitching the women back again. She also remembered nurses using abusive language and violence with patients, telling them to ‘spead your legs the way you did when you got pregnant.’

“You see women being mistreated and not being given their rights and you sympathize, [but] there is nothing you can do,” she later said.

According to Claris Oganga of the Federation of Women’s Lawyers, who spoke to delegates yesterday at the 3rd Africa Conference on Sexual Health and Rights in Abuja, the reasons for the poor state of health care in Kenya is complex and multi-faceted. Since 2006 Oganga has interviewed a number of women, health care providers, licensing and regulatory bodies, and leaders of medical associations for a joint project of the Federation of Women’s Lawyers and Centre for Reproductive Health. she found that poor access to hospitals, understaffing/lack of institutional support, demoralized health care staff, lack of supplies, unhygienic conditions, and lack of proper record keeping contributed significantly to the bottlenecks in the Kenyan health system.

The Kenyan government also holds part of the blame, with no strong commitment to issues relating to women and reproductive health, especially when considering future health budgets and care programs. There is no Minister of Health in Kenya, and no freedom of information act (though one is being drafted) to allow women to research their rights and seek redress when neglected or abused by nurses and doctors at health care centers.

Oganga recommended that government and non-profit sectors promote and develop policies and legislation that protect the rights of women seeking RH care and ensure sufficient regulation in both public and private facilities, as well as to ratify the Protocol on the Rights of Women in Africa, which explicitly recognizes the right to reproductive health care as key component of women’s fundamental human rights. She also recommended that nurses be trained on gender and human rights issues while still in college to understand the rights of their patients and to realize the impact of their care on expectant mothers.

* By Amanda Hale