As you walk into the maternity ward of Bondo Sub-County Hospital, the sun filters through the windows, casting a soft glow over the room, where mothers cradle their newborns. In one corner, a nurse gently leans over a young mother, guiding her through breastfeeding.
Back in 2021, many mothers and newborn babies were dying in Bondo Sub-County Hospital. Each quarter, the facility recorded spikes in maternal deaths, with postpartum hemorrhage (PPH) and eclampsia consistently among the top culprits. Data from the Kenya Health Information System (KHIS revealed that the facility recorded 6 deaths that year. Neonatal deaths followed a similarly troubling pattern with over 45 neonatal deaths that year, with asphyxia, prematurity, and sepsis dominating the causes.
This is Mary Akinyi, she is a new PROMPTS mother. She delivered her baby at the Bondo Subcounty Hospital. Faith Owuor a maternity nurse at the facility is helping her take care of her newborn baby. Photo Credits: Charles Kimani
But then something changed.
In 2022, a new peer-to-peer mentorship program was introduced to Bondo Sub-County Hospital, and a new trend emerged. The program, MENTORS, equipped government nurse champions to cascade critical EmONC skills down to their peers in facilities.
Soon, frontline providers, including public health officers, clinical officers within Bondo Sub-County Hospital, were learning how to rapidly identify and manage maternal and neonatal complications on the ward and perform life-saving interventions on time.
“Before the training, we often found ourselves reacting in the moment, unsure of the best steps to take. Now, we’re proactive. Every shift has at least one or two health workers who’ve completed the mentorship program and can immediately lead during an emergency,” said Nurse Victoria Omondi.
Between 2021 and 2024, the hospital saw a decrease in maternal deaths by 9%. The facility continues to be a huge referral hospital within the area, receiving over 100 cases of complications each quarter. Despite this, the facility continues to record reduced cases of maternal deaths and better neonatal outcomes.
One of the key drivers of these positive trends is the hands-on mentorship approach that our EMONC training adopts. This approach involves real-time coaching where experienced nurse mentors guide their peers through emergency procedures as they occur. It emphasizes learning by doing, allowing them to build competence while managing actual maternal and newborn complications as they arise. The frontline health workers within the facility now have the confidence to act decisively in emergencies, ensuring timely interventions that save both mothers and newborns.
“Before the training, there were no standard ways of treating these emergencies despite the high volume of deliveries. We have single established standardized practices of treating mothers, empowering everyone on the team to respond quickly because everyone is knowledgeable on the best course of action,” – Dr. George Obwak, Clinical Officer and Reproductive Health Champion.
The decrease in maternal deaths and management of obstetric emergencies reflect the impact of investing in healthcare workers. With the right knowledge, skill sets, and support, healthcare teams can change the trajectory of maternal and neonatal health outcomes in public health facilities, where most underserved women and babies seek care.