How the EMOTIVE program is saving mothers' lives in Vihiga County

In the quiet green hills of Vihiga County, the cry of a newborn signals not just a new life, but a mother’s survival. For decades, childbirth has been fraught with danger, especially in rural Kenya, where healthcare resources are stretched thin.

Among the gravest threats is postpartum hemorrhage (PPH)—a silent killer responsible for one maternal death every six minutes worldwide.

In Kenya, where maternal health resources are often stretched thin, innovative programs like the Emergency Obstetric and Newborn Care (EMOTIVE) initiative are stepping in to save lives.

Postpartum haemorrhage (PPH) - defined as the loss of more than 500ml of blood within 24 hours after birth - is currently the leading cause of maternal mortality worldwide, killing one woman every six minutes.

But in Vihiga, a groundbreaking initiative is rewriting this grim narrative.

Salome Achieng, a 30-year-old mother of three, knows this all too well. Just weeks ago, she lay in a hospital bed at Vihiga County Referral Hospital, bleeding profusely after giving birth to her third child.

The delivery had begun like her previous ones, routine and unremarkable, until it wasn’t. Achieng was experiencing severe postpartum hemorrhage, a condition that claims the lives of thousands of women every year.

"My delivery started out like the others," Achieng recalls, her voice tinged with lingering fear. "But then I began bleeding heavily. It was frightening, and I knew something was wrong."

In another time, in another place, Achieng’s story might have ended differently.

But on that day, the medical team at Vihiga was armed with the latest tools and protocols from the EMOTIVE program, an innovative approach designed to combat PPH with precision and speed.

Three years ago, most providers use visual inspection to assess bleeding, which tends to underestimate blood loss and can lead to life-threatening delays in treatment.

When treatment is provided, this is typically done in a sequential manner with gaps between each intervention - costing more time if the first options are not effective.

Now, if a woman is assessed to have severe bleeding she should be offered an immediate treatment bundle.

This would include uterine massage, medicines to contract the womb and stop the bleeding, intravenous fluid administration, an examination and, when needed, escalation to advanced care.

This new system, E-MOTIVE intervention, and all parts of it can be performed by midwives.

The EMOTIVE program, supported by the USAID-funded Momentum Country and Global Leadership (MCGL) initiative, is revolutionizing maternal healthcare in Vihiga County for the past three years now.

It equips healthcare workers with advanced tools, like calibrated drapes that accurately measure blood loss, and structured protocols that ensure rapid, effective treatment.

For Achieng, these innovations made all the difference. As soon as the bleeding began, the medical team deployed the calibrated drapes, which revealed the true extent of her hemorrhage.

This precise measurement allowed the team to act quickly, administering uterotonic drugs to contract her uterus and stem the bleeding.

They also provided a blood transfusion to replace the blood she had lost—a critical intervention that saved her life.

"The drapes made a huge difference," Achieng says. "They helped the doctors quickly understand how much blood I had lost, which was crucial for deciding the right course of action."

Achieng’s recovery was closely monitored through the EMOTIVE program’s structured observation protocols, ensuring that no signs of danger were missed.

Thanks to these timely and coordinated efforts, she is now home, cradling her newborn and reflecting on how close she came to a different fate.

For healthcare professionals like Nurse Susan Obilo, who has served at Vihiga County Referral Hospital and has over 25 years, the introduction of the EMOTIVE program has been nothing short of transformative. Managing PPH used to be a race against time, fraught with uncertainty and, too often, tragedy.

"Before EMOTIVE, managing PPH was often a race against time," Obilo explains.

"We had the skills, but the tools were not always sufficient. The introduction of calibrated drapes and structured protocols has transformed how we handle these cases. Now, we can accurately measure blood loss and follow a clear procedure, which has significantly improved our ability to save lives."

Obilo also credits the comprehensive training and mentorship provided by the MCGL program. These sessions have empowered healthcare workers across Vihiga County, giving them the confidence and skills needed to effectively manage PPH and other obstetric emergencies.

"The training sessions have been very thorough, and the mentorship has ensured that we apply what we've learned in real-time. We feel more confident and better prepared to handle PPH cases," she adds.

The success of the EMOTIVE program in Vihiga is part of a larger effort to reduce maternal mortality across Kenya.

PPH, primarily caused by poor uterine tone, trauma during childbirth, retained placental fragments, and coagulation disorders, is a leading cause of death among new mothers.

Addressing it requires not only immediate medical intervention but also systemic changes to the healthcare infrastructure.

In Vihiga County, the MCGL program has provided critical support, supplying essential equipment, PPH kits, and ongoing training to healthcare facilities.

These efforts have led to a significant reduction in PPH-related deaths, offering hope to mothers and families who once lived in fear of childbirth.

Veronica Musiga, the Vihiga County Reproductive Health Coordinator, has witnessed the profound changes brought about by the EMOTIVE program.

"We have seen a marked reduction in PPH cases across the county," Musiga states.

"The combination of advanced tools, structured protocols, and continuous training has made a significant difference. Our healthcare workers are now better equipped to manage PPH, and as a result, more mothers are surviving what used to be fatal complications."

Musiga is determined to expand the program’s reach, ensuring that every healthcare facility in Vihiga County has access to the resources and training needed to keep mothers safe.

"We are working closely with the MCGL program to ensure that every healthcare facility in Vihiga has access to the necessary equipment and training. Our goal is to make sure that every mother, no matter where she delivers, has the best chance of a safe outcome," she says.

Despite the program's success, challenges remain. Healthcare workers in the affected counties have expressed the need for more resources, particularly in terms of equipment and medical supplies.

Moreover, ongoing training and support are essential to ensure that the skills acquired through the EMOTIVE program are maintained and enhanced over time.

While the EMOTIVE program addresses the immediate threat of PPH, the broader systemic issues within Kenya’s healthcare system also need attention.

The availability of critical interventions like blood transfusions and uterotonic agents is still inconsistent, particularly in remote areas.

Another crucial aspect of the EMOTIVE program's success is community engagement. Educating women and their families about the signs of PPH and the importance of seeking immediate medical attention has been key to improving maternal health outcomes.

For mothers like Achieng, the EMOTIVE program represents a beacon of hope in a landscape that has long been shadowed by fear and uncertainty.

And as the EMOTIVE program continues to expand, more mothers like Achieng can look forward to safe deliveries and healthy futures, free from the fear of postpartum hemorrhage.