A new study, titled ‘A Price Too High to Bear,’ was conducted from 2011 to 2013 by Family Care International (FCI), the International Center for Research on Women (ICRW), and the KEMRI-CDC Research and Public Health Collaboration.
It shows that far too often a maternal death is directly linked to neonatal mortality. Among the 59 maternal deaths examined, only 31 infants (52%) survived delivery. Of these 8 babies died in their first week of life and another 8 died over the next few weeks. In all only 15 babies (25%) survived. Some older children whose schooling was interrupted had to leave the family home to live with relatives. Husbands and older family members, particularly mothers and mothers-in-law, had little time to grieve, as they immediately began taking over the deceased women’s household and childcare responsibilities. When they lose a loved one to maternal death, families are confronted with medical and funeral costs greater than their total household spending in a typical year.
As the United Nations Millennium Development Goals’ 2015 deadline approaches, these findings are critically important as countries like Kenya work to accelerate their progressin reducing preventable deaths among their most vulnerable populations, strengthen theireconomies, and set themselves on a path of sustainable national development.
While global maternal deaths were cut almost in half between 1990 and 2010, Kenya’s maternal mortality ratio declined only slightly during the same period, going from 400 per 100,000 births in 1990 to 360 per 100,000 births in 2010. Maternal health advocates have argued that concerted action is needed to reduce preventable maternal deaths in Kenya, where less than half of all births are attended by a midwife or other skilled health worker.
‘This new research puts hard numbers, as well as heart-breaking stories, behind a message that maternal health advocates have known for years: when women die, children suffer and families fall apart,’ said Ann Starrs, president of FCI. ‘These findings reinforce the compelling moral and economic case for urgent action to end preventable maternal deaths, in Kenya and around the world.’
The new study was conducted in three sub-counties within Siaya County, which was carved out of the former Nyanza Province in Kenya’s 2013 redistricting. In this region of western Kenya, northeast of Lake Victoria, poverty is pervasive. Reproductive, maternal, and child health indicators are worse than national averages, and rates of HIV, TB, and malaria are among the highest in Kenya.
‘Over more than a decade of surveying the population in this part of Siaya County, we have seen over and over again the devastating consequences of maternal death for children and families,’ said Dr. John Vulule, Director of KEMRI/CDC. ‘This study tells the story clearly and in detail.’
‘This critically important research shows us, yet again, that the costs of maternal death are indeed far too high for the Kenyan people to bear,’ said Dr. Simon Mueke, Head of the Reproductive and Maternal Health Services Division, Kenya Ministry of Health. ‘Across Kenya, in every county, we must and will commit ourselves to ensuring that every woman has access to high-quality antenatal, maternity, and postnatal care, and that the families who suffer these devastating losses receive the support services that they desperately need.’
The study’s findings, which are expected to be published in a series of scientific journal articles during 2014, show that families experiencing a maternal death spent more on medical care and funeral expenses than all other yearly expenses combined, including food, shelter, and education. The amounts ranged from 102% of annual consumption costs for lower-wealth households to 148% and 123%, respectively, for middle- and higher-wealth households. Many adult family members also had to take time off from work during the health crisis and funeral period, causing a further economic loss. In nearly half of all cases, families had to sell household property or borrow money from family members or moneylenders, in order to stay on their feet.
‘A great deal is known about what causes maternal mortality, and about the health interventions that can prevent it. We undertook this study because there has been relatively little research on what a maternal death means for the family that is left behind,’ said Sarah Degnan Kambou, President of ICRW. ‘Our results show that the cost of maternal mortality is truly a price too high to bear’. This research was conducted, in cooperation with the Government of Kenya, with the financial support of the UK Government; the John D. and Catherine T. MacArthur Foundation; and the Partnership for Maternal, Newborn & Child Health. ‘The message is clear,’ said Ann Starrs of FCI. ‘The time to act on maternal health is right now.’