01 September 2013

Kiribati's Baby Friendly hospital making a difference

By Karen Allen, UNICEF Pacific Representative
Tabera 26 breastfeeding her four-month-old son Tekea at home
© UNICEF Pacific/2006/Pirozzi
There are three hospitals in the nation of Kiribati, and the main referral hospital is Tungaro. This is the first of three to achieve certification of being "Baby Friendly" - a set of standards to ensure newborns are well cared for and mothers encouraged to breastfeed. The Antenatal Care Clinic is simple. It is clean and staffed by bright and caring staff. 

The mothers on the day that I visited, were pregnant with their fourth or fifth child, and they seemed either resigned or relaxed about it. At this clinic, with UNICEF support, all pregnant women are also screened for HIV/AIDS and other sexually transmitted diseases. They are also counselled and referred for treatment, if necessary.

I visited a 24 bed maternity ward, and arrived minutes after a newborn did - the baby was just being swaddled and brought to his mother. Pregnant women were lying just outside the birthing room, in the hallway, and outside the building as there simply isn't space for all of them. (Fertility in Kiribati remains high and a stronger birth spacing programming is a must for improving maternal and child mortality rates.)

The nurses proudly informed us that they are able to persuade about 90% of mothers to exclusively breastfeed - we wish it were 100%, but they are right to be proud.

In the premature neonatal unit, five out of six incubators were occupied, all well monitored.  One mother had been medevaced by the Government from an outer island, with her baby's leg born and labour obstructed. I can scarcely imagine what her trip was like...but thank goodness, the obstetrician at Tungaro was able to save mother and child.

Next door, where older infants need intensive care, conditions are in dire need of improvement, but the staff is doing its best with limited resources and high demand for services. Mothers stay with their babies so that breastfeeding continues. Most of the infants in this unit have acute respiratory infections or diarrhoea, one was severely malnourished. Overcrowded living conditions, shortage of clean, fresh water, and low sanitation and hygiene conditions underlies these very sad cases.

UNICEF's support to the Baby Friendly Initiative is appreciated, but we would like to do more -- extend this to the other hospitals, and purchase some much needed, essential newborn care equipment.

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