High rates of maternal, neonatal and child mortality continue to exact a terrible toll in rural Kenya, where fewer than half of all deliveries are attended by a nurse or midwife.

The Aga Khan University (AKU) and the Community Health Department of the Aga Khan Health Service, Kenya are working in poor rural communities in three districts of Kenya’s Coast Province to help public health professionals deliver better care to mothers and young children. The Mama Na Mtoto project – mother and child in Kiswahili – provides community-based training for midwives, nurses and other health workers in 10 local health facilities in the districts of Kwale, Kinango and Msambweni. There almost three-quarters of residents live below the poverty line.

AKU is carrying out the operational research component of the project, which will help improve understanding of maternal and child health needs in these and other rural communities. One study, led by the Department of Obstetrics and Gynaecology at AKU’s Medical College, East Africa, seeks to understand why many women prefer to deliver at home rather than at the nearest health facility. One early finding is that while distance is a major factor, sometimes the main barrier to using health facilities is cultural.

“Many cultures have a tradition of burying the placenta after delivery,” noted Dr Amyn Lakhani, Director, Community Health Department, AKHS, Kenya. “Government health facilities don’t do that. Instead, they throw the organ away, distressing people who feel that improper respect has been shown to their baby’s placenta.”

Meanwhile, a verbal autopsy study led by AKU’s School of Nursing and Midwifery, East Africa aims to collect reliable information on the causes of maternal and child mortality by asking relatives and caregivers about the signs and symptoms that preceded death. Findings from both studies will be shared with the provincial government as part of advocacy for appropriate reforms.