MFANGANO ISLAND, Kenya – In her four years at the Sena Health Center, midwife Goretti Adhiambo lost too many lives to complications from pregnancy and childbirth. “We provide all basic maternal health services at the health center, including prenatal care, but complicated cases need to be referred to the mainland hospital for specialized care,” she said.
Their health center is located on the remote island of Mfangano in Homa Bay County, Kenya. To get to the mainland town of Mbita for treatment, it takes at least an hour by boat – two if the water is choppy. During an obstetric emergency, this delay can be fatal.
In 2018, Ms. Adhiambo was treating a young woman with childbirth complications. The woman was referred to the mainland for specialized care, but died on the transfer to Mbita. “She was only 18 years old and losing such a young life was very painful for my colleagues and me,” recalls Ms. Adhiambo.
Today Ms. Adhiambo looks after expectant mothers and newborns as a midwife. And she has a new tool in her arsenal that she can use to spot complications long before they become life-threatening: an ultrasound machine.
Put tools in the hands of midwives
For years, pregnant women on the island of Mfangano have not only had to travel to the mainland for emergency obstetric care, but also for diagnostic services such as an obstetric ultrasound examination. Such instruments are often only available in specialized healthcare facilities in larger cities and metropolitan areas. As a result, pregnancy complications are often only recognized with great effort, too late for treatment or not at all.
Midwives practice using the portable ultrasound machine during a class at Oseri Hospital in Kisii County, Kenya. © UNFPA Kenya
But that is starting to change.
Through a partnership between UNFPA, AMREF International University, and the Phillips Foundation, wearable ultrasound technology – and training – is being made available to midwives from distant health centers in remote parts of Kenya.
Ms. Adhiambo and others recently learned how to use the handheld device known as the Lumify Probe from experienced sonographers who guided them in the following skills: confirming pregnancy is viable, visualizing and seeing the number of fetuses, identifying the number of fetuses Location in the uterus is the placenta and detects the position of a fetus. By identifying problems such as the breech position of the fetus or multiple pregnancy, midwives can better advise, monitor and refer.
“If midwives are able to perform basic obstetric ultrasound examinations at the point-of-care, pregnancy complications can be detected early and referred to higher-level health facilities in good time,” said Priscilla Ngunju, project coordinator at AMREF International University. “Our hope is that more mothers, in line with World Health Organization recommendations, will have access to at least one obstetric exam before the 24th week of pregnancy.”
Capable of saving lives
The trained midwives also received Lumify probe devices for their healthcare facilities. And because the device is portable, midwives can take it with them on home and community visits, expanding the reach of these important services.
In addition to eliminating transportation costs to the mainland, the program significantly reduced the cost of ultrasound exams. Ultrasounds in the clinic cost Ksh 500 (about $ 5), while in specialized health facilities they can be twice or three times as expensive.
Ms. Adhiambo says she is glad that the expectant mothers she cares for at the Sena Health Center have been spared these burdens.
“I learned a lot from the training, including interpreting an ultrasound image, locating the placenta, and detecting major birth defects,” she told UNFPA. “I can now use my skills to save a mother’s life.”