The health ministry has over the years put in place and reinforced strategies geared towards ending preventable maternal, newborn, child and adolescent deaths.
This has been coupled with efforts intended to improve the health and quality of life of women, adolescents and children through increasing the availability and access to Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCAH) services.
Comparing the two financial years; FY 2015/16 and 2019/2020, the Ministry of Health has registered a 17% reduction in the maternal deaths among 100,000 facility deliveries.
Dr Joyce Moriku Kaducu, the State Minister for health in charge of Primary Health Care has stated that the health sector has made an achievement in curbing mortalities in the Financial Year 2019/20.
“Overall, the sector has made a remarkable progress in the reduction of maternal deaths falling short of the Health Sector Development Plan (HSDP) target by 1%,” she said.
This, she said, can be attributed to the improved access and quality of services due to the RMNCAH projects like the Uganda Reproductive Maternal and Child Health Service Improvement Project (URMCHIP), Voucher plus, PNFP/Institutional Capacity Building project (ICB) II, Uganda Reproductive Health Voucher Project, Strategic Purchasing of Health Services in Uganda (SPHU), USAID-Uganda Voucher plus Activity, Regional Health Integration to Enhance Services (RHITES) among others.
This has also been coupled with partner support from the World Health Organisation (WHO), United Nations Children’s Fund (UNICEF), United Nations Population Fund (UNFPA), Save the Children among others.
The Ministry of Health analysis report indicates that 36% of maternal deaths occurred among young mothers of less than 24 years, an age bracket required to be in school. Teenage pregnancies contribute up to 10% of all maternal deaths.
The Minister recommended a multi-sectoral approach geared towards ensuring that girls are kept in school and life skills development for those out of school together with improvement on capacity of health facilities to offer good quality adolescent and youth Responsive and Sexual Reproductive Health and Rights Services.
Obstacles in maternal health service delivery
The ‘RMNCAH Sharpened Plan for Uganda 2016/17 – 2019/20’ points out that maternal mortality rates fell by only 20% over the past 20 years, decreasing too slowly to achieve national targets.
It also indicates that the “unacceptably high number of maternal deaths annually in Uganda account for 2% of the annual maternal deaths globally.”
The plan data also shows that the major causes of maternal deaths are preventable with the leading causes including haemorrhage, obstructed labour and complications from abortion.
Unfortunately, the plan reveals, almost 28% of maternal deaths in Uganda occur in young women aged 15 to 24 years and 60% of premature deaths among adults are associated with behaviours or conditions that began or occurred during adolescence.
The overall adolescent birth rate in the age category 15 to 19 years is at 135 per 1000 live births, which ranks among the highest in the Sub-Saharan Africa driving both total fertility and population growth rates.
Adolescents aged 15 to 19 contribute 17.6% to the country’s overall death toll due to pregnancy related complications.
The outbreak of Covid-19 and the subsequent lockdown has greatly affected the normal running of healthcare service delivery with the restriction on public transport that barred those in need from accessing health facilities.
The ministry notes that health facility deliveries declined from 63% in the FY 2018/19 to 59% in the FY 2019/20 as many pregnant women could not access the health facilities.
Most deliveries that contribute 73% are conducted at Primary Health Care facilities which are inadequately staffed, equipped and lack staff accommodation to ensure 24 hour coverage, according to Dr Kaducu.
“The Ministry of Health is addressing this by ensuring that all sub counties have functional Health Centre three facilities to provide obstetric care services,” she revealed.