How Kilifi's binti-to-binti group is tackling tragedy of stillbirths

Ms Mary Furaha joins pregnant women under trees outside the Dzikunze dispensary in Ndugumnani village, Kilifi County.

The 23-year-old mother, who is eight months pregnant, visited the clinic for her monthly antenatal check-up. This visit was not her usual routine as she was experiencing abdominal pains.

This visit was not her usual routine, as she was experiencing abdominal pains. The gestation period was expected to be smooth with no complications, unlike her firstborn, who she gave birth to at home three years ago.

"I had a challenging first pregnancy as a first-time mother. I didn't start my prenatal care early, which led to complications. Eventually, I gave birth to my first child with the help of my mother, assisted by a midwife, on a mat at home," narrated Ms Furaha.

She knew the dangers of skipping antenatal care and opted for a new approach. But life in the remote village of Ganze poses significant challenges for pregnant women.

Some women in rural Kilifi skip doctor's appointments due to distance. The county government has set up Binti-to-binti support groups to help these mothers.

It is a maternity, open-day learning group designed to ensure that rural mothers seek Antenatal (ANC) services during their first trimester and embrace good nutrition practices in their communities.

The groups are aiding thousands of rural women in Kilifi to have a healthy pregnancy and safe birth thus reducing maternal mortality rates since last year.

The groups offer pregnant women the chance to learn, share concerns, and get help during their pregnancy journey. Childbirth, breastfeeding, and parenting resources are scarce in rural areas, making support groups crucial. They also dispel taboos and correct misinformation.

Ms Furaha attended this month’s group meeting with other expectant mothers from her village. She is optimistic that the abnormal pain will stop and she will deliver her second born with ease.

During our hospital visit, Ms. Salome Kalama, the nurse in charge at the Dzikunze Dispensary, led a brief interactive session on maternal and pediatric health.

Pregnant women experiencing unusual discomfort must go to a health facility for consultation whenever they feel pain and discomfort. Mary did exactly that.

At the clinic, she received reassurance about her pregnancy and medication for the pain.

“The group has helped me. The mothers are very open with each other about whatever issues they are having,” said Ms Furaha. It’s a safe space to discuss such subjects that women might feel uncomfortable discussing elsewhere.

Ms Furaha joined the peer group when the process was emotional and overwhelming. There was more to learn, from how to eat healthy foods for breastfeeding to health interventions to improve postpartum outcomes.

"In the past, I did not have a plan on how to do around birth. Now I have planned everything from food, fare, a motorbike that will take me to the hospital to deliver and return me home," she said.

In the groups, they encourage sharing experiences and reminding each other to eat iron-rich food and attend ANC visits. As members of the group, the women are also given Iron and folic acid supplements (IFAS) for healthy pregnancy and growth of the fetus.

"When I take IFAS I'm able to sleep peacefully unlike before when I used to feel tired," said Furaha, adding that during her first pregnancy, she could feel weak, dizzy, and body pain.

With her second child on the way, Ms Furaha said she would be more active in the Binti-to-Binti group, sharing information with her peers and practising what she learns.

Ms Kalama, the nursing officer at Dzikunze dispensary, says pregnant women are offered free prenatal care, birthing services, and medical aid.

“They are empowered to ensure the health of babies. We prioritize conception, pregnancy, delivery, and post-delivery, as well as children's ongoing needs like nutrition and immunization.

Kilifi County health data shows that last year, at least 43,243 deliveries were recorded, out of which at least 4,129 babies had low birth weight, a slight drop from 4,413 in 2022.

The data further documented 26 maternal deaths last year, a drop from 31 in 2022. The groups have also encouraged husbands to accompany their wives during hospital visits.

Health caregivers say that IFAS supplements have reduced genital abnormalities in the area and increased Hemoglobin levels in pregnant women.

In addition, trained Community Health Promoters (CHP) visit villages to educate mothers and register them in the groups.

The CHPs highlight best practices for maternal care and nutrition, vitamin A supplementation, de-worming medication, and nutrition monitoring– all of which can improve pregnancy outcomes and infant health.

Gabriel Ngumbao, a CHP at Mwangea-Mwele village said he educates mothers about the benefits of certain services and they understand.