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Refugees in Kenya visit antenatal clinics for the first time


Summary of story from IRIN, September 14, 2011

Most Somali women fleeing to the northeastern Kenyan town of Dadaab have never visited an antenatal clinic – let alone given birth in a hospital.

According to the UN World Health Organisation (WHO), most of the 470,000 refugees in Dadaab are from Somalia, where about 80 per cent of deliveries take place at home or with unskilled traditional birth attendants.

With an estimated 1,400 maternal deaths per 100,000 live births, WHO describes maternal and prenatal health in Somalia as being “of pressing concern”.

“Many of these women have lived here but you find some do not even know that they can visit the clinic or some know where the clinics are but they don’t want to seek such services, mostly for cultural reasons. It is my work to convince them,” says Miriam Ade, a community health worker in the Ifo camp.

Fatuma Ali, a 27-year-old Somali refugee, delivered all her five children at home. When she fled Somalia for Kenya 10 months ago, she was pregnant; community health workers in Dadaab persuaded her to attend a local antenatal clinic.

“In my country there are no hospitals, and we don’t even believe in going to the hospital,” she said.

“There are people who tell us it against our culture to go to hospital to give birth. After I was registered as a refugee here, I used to attend the clinic and they have even tested me for HIV; they have taught me how to feed my child and I received soap and sanitary towels soon after I delivered and went back home.”

Ms Ali was also treated for complications stemming from a genital mutilation procedure, and she received family planning advice as she did not wish to have any more children.

According to Beldina Gikundi, the reproductive health focal point for the International Rescue Committee (IRC) in Dadaab, community health workers have been crucial in boosting the uptake of reproductive health services among women in the camp.

“Many women still believe in home delivery and many more people still do not believe in discussing issues of sexuality that easily, but with the use of community health workers, we have been able to reach out to them to seek both reproductive health and HIV services,” she said.

However, the camp is struggling to cope with a huge demand for services. Thousands of refugees from Somalia arrive daily and only IRC and Medecins Sans Frontieres have fully operational maternal health clinics.

“Many mothers either die or lose their children due to the poor conditions they give birth in at the camps… The facilities can only cater for so much,” Ms Gikundi said, adding that, “the contraceptive rate is low, hence very high fertility rates are putting pressure on resources at the maternity facilities. We are, however, doing everything to ensure the uptake of contraceptive use.”

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