Ensuring good maternal and neonatal health in Uganda has been one of the key priorities focused on in the country’s health sector.
However, the efforts have been weakened with the rise of new challenges that face both the expectant mothers, the new born children and the health care workers in the maternity section.
According to the August 2017 Maternal and Perinatal Death Surveillance and Response Guidelines by Ministry of Health’s Reproductive Health Division, Uganda is among the countries struggling with high maternal mortality rates at 336/100,000 live births.
The response guidelines also indicated that the neonatal mortality in Uganda is estimated to be 27 deaths per 1000 live births and accounts for 45% of the under-five mortality.
Caroline Busingye, a midwife from Kitagata Hospital – Sheema district revealed that pregnant mothers who delay to report to health facilities at the notice of labour signs are exposed to risks of losing the baby or even dying themselves.
Having spent 20 years in the midwifery section, she has worked in several health centres including Kigoba Health Centre III, Kabuzimbi HC, Bugonju HC III in Bushenyi and is now currently working at Kitagata Hospital.
She said that the delay of these mothers in seeking attention from the midwives during the child delivery process causes serious health challenges to the mother and the unborn child and this results from various factors which make it impossible for them to reach health care centres in time.
“They delay in the communities when they are coming for delivery due to hindrances in transport, poverty, and also inefficiency in other lower health facilities because they don’t have ambulances. When they call the boda bodas, they can’t move very late in the night so these mothers have to wait till early morning to be able to move,” she explained.
The other challenges like limited equipment used in child delivery and the presence of few midwives to serve the big population in the few available health centres have also hindered the smooth running of the maternity section, she added.
Busingye’s wish is that more midwives get trained “because they are generally few especially when it comes to attending to the many emergencies that may randomly happen.”
Busingye also shared her great achievement as a midwife in the past two decades.
“At least during my 20 years down the road, I have never had any maternal, neonatal deaths and i am grateful for that,” she said.
The 2017 report by ministry of health, USAID Assist Project and other partners on “Improving Maternal and New born Care in Northern Uganda” indicated that Uganda’s maternal and new-born mortality remains unacceptably high (438 maternal deaths per 100,000 live births and 27 per 1,000 live births respectively).
Most of these deaths occur around the time of labour, delivery and immediate postpartum.
In the 2018 report on Levels and Trends in Child Mortality by UNICEF, WHO and others, it was noted that improving the survival chances of new-bornes, children and young adolescents remains an urgent challenge that needs to be solved.
Therefore, in order to address the problem, the Ministry of Health, together with partners initiated the Uganda Reproductive Maternal and Child Health Improvement Project (URMCHIP).
The URMCHP project is intended to enhance utilisation of health services with a focus on Reproductive Maternal, Neonatal Child and Adolescent Health services (RMNCAH); under URMCHIP.
According to the Ministry, the project intends to benefit women of child bearing age, adolescents and children under 5 years of age.
The government, through the ministry of health has invested in training of health care workers and provided support supervision to different health workers.
This is evident with the recent support supervision conducted by a team from the Ministry of Health led by the Permanent Secretary Dr Diana Atwine, to strengthen maternal and child health service delivery in the West Nile.