Bungoma county has intensified efforts to improve the survival and quality care for preterm babies, rolling out targeted interventions aimed at strengthening neonatal units, training health workers and equipping facilities with life-saving technology.

The renewed push comes amid concerns over high rates of premature births and related complications with Dr. Felicitas Makokha, neonatologist and the head of the newborn unit (NBU), Bungoma County Referral Hospital Mother and Baby hospital expressing optimism that the measures will significantly boost survival outcomes for the most vulnerable newborns in the county.

She said that the newborn unit has a bed capacity of 100 with six rooms and a Kangaroo mother care (KMC).

Dr. Makokha explained that upon arrival at the facility, newborns are first received in the admission room where they undergo immediate triage and a thorough assessment to identify any danger signs.

He noted that medical staff promptly carries out an ABCD assessment checking the airway, breathing, circulation and any signs of disability to determine the baby’s condition and urgency of care.

In cases where the infant requires support, whether respiratory assistance, circulatory stabilization or airway management, these interventions are initiated without delay.

Additionally, each baby is carefully weighed at admission as accurate weight measurements are critical in guiding treatment decisions, particularly in determining the correct dosage of medications and overall care plan.

 “We have a newborn admission record that we use to admit the babies, stabilize them and once they are stable we move them to their respective rooms,” she stated.

Further, she explained that the newborn unit has a designated acute room where premature babies are cared for after they have been stabilized from admission

“We also have a preterm room where we keep our small and sick newborns’ who most of the time are on bubble continuous airway pressure, fluids through infusion pumps and phototherapies, jaundice and incubator care,” she said.

He noted that those in acute one, once stabilized, they are moved to acute two where they require less care, just completing treatment and phototherapy and jaundice management.

Dr. Makokha reported that the unit has the isolation room where babies with suspected or confirmed infections are confined.

She explained that the facility officially moved into the new Newborn Unit in August 2025, marking a significant milestone in improving maternal and child healthcare services.

Prior to this development, both the maternity and newborn units were housed within the main hospital building where space was extremely limited.

She noted that the entire setup consisted of only two rooms, including the Kangaroo Mother Care (KMC) section which was often overcrowded and unable to adequately accommodate the growing number of mothers and newborns in need of care.

The congestion not only strained available resources but also posed challenges in delivering efficient and quality healthcare services.

However, she commended the County Government of Bungoma for investing in the construction of a dedicated Mother and Baby Hospital.

According to her, the new facility has significantly eased congestion, created a more organized and spacious environment for both patients and healthcare workers and ultimately improved the quality of care provided to mothers and their newborns.

She pointed out that the common causes of new born admission are prematurity, perinatal asphyxia, infections and birth defects.

“Prematurity is the main cause of mortality and the common cause of preterm for those cases where we are able to establish is mainly pregnancy associated hypertension, preterm rapture of membranes and infections in pregnancy like malaria,” she said.

Dr. Makokha reported that the unit records an average of between 120 -150 admissions every month, an indication of the high demand for specialized newborn care services at the facility.

She noted that the majority of these cases involve premature babies, low birth weight infants and newborns presenting with complications such as infections or breathing difficulties that require close monitoring and medical intervention.

She added that the steady flow of admissions places significant responsibility on the healthcare team, who must ensure that each baby receives timely and appropriate care despite the workload.

However, with the improved infrastructure and expanded space in the new unit, the facility is now better equipped to handle the increasing number of admissions while maintaining quality care and improving survival outcomes for newborns.

She said that being a referring facility, they receive babies from the neighbouring counties of Kakamega, Busia among other regions.

Dr. Makokha pointed out lack of oxygen piping in the facility as a major challenge affecting their services.

“We have a partner in place who has pledged to help the facility with oxygen piping because we are currently using cylinders which are not suitable,” she said.

She added, “ The facility has a vision of having a newborn ICU, currently what we are lacking is neonatal ventilators and ICU beds, once we get those then acute one room will be converted into an neonatal intensive care unit,”

She affirmed that the facility doe’s mentorship for lower level facilities and training for service providers.

She underscored that Bungoma has seen a tremendous improvement in survival of babies, “before we had this level of care, babies born with less than 1,000 grams were not surviving but the survival has improved.”

At the unit, she says that there a 10 bed capacity Kangaroo room where preterm babies who are stable are admitted to be started on Kangaroo mother care and nursed until they are 2Kgs and later discharged.

“While they are kept skin to skin tied up, a kangaroo position upright on the mothers chest between the breast, we have kangaroo wraps and every three hours the mother either feeds the baby through tubes or by cup and as they grow older we start teaching them on how to breastfeed,” she said.

“However, while there, they give babies supplements: iron, folic acid, vitamin D, calcium based on the baby’s calcium levels,” she said.

The mothers are also taught the danger signs of the newborns so that when go home they are able to detect if the baby has the problem.

Dr. Makokha said the facility is in the process of creating room for new type of kangaroo called immediate kangaroo mother care that is able to put a baby in the KMC without waiting for them to stable.

She explained that under the current practice of Kangaroo Mother Care (KMC), babies are only introduced to the method after they have been stabilized and are no longer dependent on intravenous fluids or oxygen support.

She noted that the approach ensures that the infant is strong enough to benefit from continuous skin-to-skin contact with the mother.

However, she pointed out that in Immediate Kangaroo Mother Care, the process begins right after birth, without waiting for the baby to be weaned off medical support.

This, she said, requires a more comprehensive setup, including a well-equipped space with beds that can accommodate both the mother and the baby.

She emphasized that such an arrangement is crucial because mothers also need close monitoring and care after delivery, making it necessary to provide a supportive environment where both can receive simultaneous attention from healthcare providers.

She added that the room adjacent to the current Kangaroo Mother Care is earmarked for renovation to start immediate Kangaroo mother care which studies have shown that for babies born between 1,000 to 1,750 grams when started on Kangaroo Mother care immediately without waiting for stability the survival is better than when you wait.

Dr. Makokha cited teenage pregnancy problem in the region, stating that teen mothers have high risk of getting preterm babies and when they get preterm babies they are not psychologically prepared to be mothers.

“Some of these mothers struggle with lactation initiation and feeding babies and even with healthcare financing they don’t have identity cards therefore not enrolled up for Social Health Authority (SHA) so it really becomes a challenge,” she said.

Centrine Naliaka, a mother currently admitted at the Bungoma County Referral Hospital Newborn Unit under the Kangaroo Mother Care section, shared her experience after giving birth to a premature baby at six months.

She explained that her baby was immediately taken through the necessary medical procedures and closely monitored by healthcare providers to ensure survival and recovery.

She revealed that at birth, the baby weighed only 1 kilogram, a condition that required specialized care and constant attention.

However, through consistent treatment, proper feeding and the support offered under Kangaroo Mother Care which involves skin-to-skin contact to help stabilize the baby the infant has shown remarkable improvement.

Naliaka noted with relief that her baby is now stable and has gained weight to 1.3 kilograms, expressing gratitude to the medical team for their dedication and care that has given her child a fighting chance.