Kajiado County, situated in the former Rift Valley province, spans an area of 21,292.7 square kilometers. As of the 2019 census, the County is inhabited by a population of 1,117,840 residents, with the majority belonging to the Maasai community. Kajiado County shares its borders with Nairobi, Makueni, Narok, Nakuru, Kiambu, Machakos, Taita Taveta, and Arusha (Tanzania).
The Maasai, who are Plain Nilotes and traditionally nomadic, are renowned for their pastoral way of life and unique cultural practices that incorporate indigenous knowledge to address everyday challenges. Their preference for traditional herbal remedies and characteristic cow-dug huts, known as manyattas, reflect their distinct lifestyle. However, the nomadic nature of the Maasai presents challenges in establishing essential social infrastructure such as hospitals. Consequently, expectant mothers often opt for home births, which come with inherent difficulties, including the risk of disabilities, infections, health complications, and even fatalities. Traditional Birth Attendants (TBAs) are prominent in promoting home deliveries in Kajiado.
To address this challenge, the Department of Health has formulated innovative and distinctive approaches to promote hospital deliveries within the County. These initiatives involve the transformation of TBAs into advocates for hospital births, alongside the construction of manyatta maternal shelters within hospital premises to encourage expectant mothers to opt for hospital deliveries.
Implementation of the practice
Engaging traditional birth attendants for home deliveries is common in various African settings. However, with the advent of modernization and the emergence of new diseases and infections, this practice has become less recommended. Many women are now afflicted by Non-Communicable Diseases (NCDs), including different forms of cancer, hypertension and heart conditions.
To address these challenges, in February 2023 the Kajiado County Government initiated a series of training workshops for TBAs, emphasizing the importance of hospital-based childbirth to reduce complications and the risk of maternal or infant mortality. Subsequently, from February to May the County constructed eco-manyattas within hospital compounds to accommodate Maasai women who prefer giving birth in a manyatta setting.
The County maintains a database of experienced TBA who are well-recognized within their communities. Further, it provides an incentive of Ksh 500 for each hospital referral made by these TBAs to expectant mothers.
To ensure the long-term viability of this program, the County has incorporated it into the County Integrated Development Plan. This strategic move allows for the ongoing construction of additional facilities in various regions to further expand the initiative's reach.
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