Saturday, October 18, 2014

Emergency Obstetric & Newborn Care Saved My Wife & Son

Written by Denis Okwir 

A member and a White Ribbon Alliance (WRA) Uganda trained Citizen Journalist in Lira District. Denis is also Coordinator of Youth for Life Uganda, a community based organization. He tracks progress on maternal and newborn health in Lira District. By doing this, he is holding the Government of Uganda accountable to its commitment to improve life-saving care for pregnant women and newborns at health centers III and IV. 

My wife Anna was expecting our first child on October 13th 2014, but delivered a baby boy on August 1st 2014, two months before her due date! She had been diagnosed with Oligohydramnios [a condition in pregnancy characterized by a deficiency of amniotic fluid]. The doctor told us that the fluid which keeps the baby was over due to ‘leaking’ and that any time; the baby was going to come out. Anna was told to go for a diagnostic scan and the report from the ultra-sound showed that the baby was very okay but the fluid around it was little. This was shocking news to Anna and I. Being first time parents; we had no experience and never heard of such a condition. She was told to go for ultra-sound scanning every two weeks. I bought pads for her every day because she was ‘leaking.’ It was quite costly and worrying. This went on for three months, having started when she was five months pregnant. She was told by doctors to go on bed rest with medication.

Anna breast feeding her baby
On August 1st 2014, her condition worsened and doctors recommended emergency surgery to save her life and that of the unborn baby. Anna was operated successfully, giving birth to a premature baby boy. I feared our child would die and had many sleepless nights because it did not breast feed for two days yet its weight was only 1.6 kg. Our son was kept under intensive care for 12 days and this intensive unit has been very instrumental in reducing numbers of babies dying during birth. Our son, Sam Hopeo is a healthy boy and his mother Anna is a healthy loving mother. We are thankful to God and secondly to midwives at Ogur Health Centre IV where my wife first received care and to Dr. Robert, Dr. Sara and consultant Dr. Tiri at Lira Regional Referral Hospital for their tireless efforts to save Anna and the newborn’s life.

As a citizen journalist and an advocate for safe motherhood, I am now more energized to move around villages and communities to encourage pregnant women to attend antenatal care and deliver from health facilities because it helps to identify complications early enough for appropriate and timely care. My wife had been going for antenatal care regularly and this helped us to identify the problem early.

Call to Government: My call to the Government is to support our health centers III and IV with life-saving equipment to help detect and treat complications during pregnancy and birth early so that they can be addressed. Our health workers should be well motivated and equipped with what they need to deliver quality health services.

Advice to my fellow men:  A responsible husband should play his part when the wife is pregnant. I have had a real life experience of the issues (obstetric and newborn complications) we have been advocating for as citizens under White Ribbon Alliance for Safe Motherhood. Together with fellow residents in Lira District under ACT NOW TO SAVE MOTHERS campaign, we have been campaigning to Government to increase Emergency Obstetric and Newborn care services at our health centers III and IV in the district-as a result our district has allocated funds to renovate and equip the operating theaters at Ogur and Amach health centre IVs.  Buying food for women is not enough. Husbands, give your wives all the support they need during pregnancy, childbirth and after birth.

Thursday, October 2, 2014

Development Partners Support the Creation of Global Financing Facility to Advance Women’s and Children’s Health

Posted by Senfuka Samuel

It's your responsibility to ASK your National Leaders (President, Ministers of Health and Finance, MP etc) to commit to ACT and fulfill their promises to improve#maternal and #child health in Uganda. #ActNowToSaveMothers#commit2deliver #MDGMomentum.

Below is a Press Release By The World Bank

New facility sets course to accelerate completion of the Millennium Development Goals and end preventable maternal and child deaths by 2030
NEW YORK, September 25, 2014–The World Bank Group and Governments of Canada, Norway, and the United States announced today that they will jumpstart the creation of an innovative Global Financing Facility (GFF) to mobilize support for developing countries’ plans to accelerate progress on the health-related Millennium Development Goals (MDGs) and bring an end to preventable maternal and child deaths by 2030.
The GFF, in support of Every Woman Every Child, is being developed in close collaboration with a broad range of stakeholders, including partner countries; the H4+ agencies (UNICEF, UNFPA, WHO, UNAIDS, UN Women and the World Bank Group); civil society organizations; bilateral and multilateral development partners; foundations; private sector and others working in the areas of reproductive, maternal, newborn, child and adolescent health. The GFF will support countries in their efforts to mobilize additional domestic and international resources required to scale up and sustain essential health services for women, children and adolescents.
The initial donor commitments to the World Bank Group for the GFF include grants in the amounts of $600 million from Norway and $200 million from Canada. The GFF resources will be provided to countries in conjunction with low-interest loans and grants from the International Development Association (IDA), the World Bank Group’s fund for the poorest countries. Based on strong country demand for health results-based financing programs, these bilateral contributions could leverage up to an estimated $3.2 billion from IDA, for a total of up to $4 billion in financing to support MDG acceleration and improve reproductive, maternal, newborn, child and adolescent health.
The U.S. Agency for International Development (USAID), on behalf of the United States, is committed to working with partners to establish the GFF, bringing its full arsenal of innovative financing mechanisms and public-private partnerships to the collaboration. Aligning USAID's support through these complementary mechanisms could bring upto $400 million in leveraged resources to these efforts.
“The creation of the Global Financing Facility will enable us to transform the business of global health and development with scaled-up, smart, and sustainable financing, so that all women and children have access to lifesaving care,” said World Bank Group President Jim Yong Kim. “This signals our collective resolve as development partners to help countries push further and faster to bring an end to preventable maternal and child deaths and extreme poverty.”
The support to create the GFF was announced by global leaders at the high-level event for Every Woman Every Child during the 69th UN General Assembly. The GFF will be designed to support the goals of the Every Woman Every Child global movement and the Global Strategy for Women’s and Children’s Health, launched by UN Secretary-General Ban Ki-moon during the UN Millennium Development Goals Summit in September 2010, and supported by the G-8 Muskoka Initiative on Maternal, Newborn, and Child Health, launched under the leadership of Canadian Prime Minister Stephen Harper.
UN Secretary-General Ban Ki-moon said, “Under the Every Woman Every Child partnership model, the health community is leading the way in finding innovative solutions and expanding new partnerships. For the first time ever, we have the historic opportunity to end all preventable maternal, newborn and child deaths within a generation. This new funding boost and innovative financing approach will help us get closer to that goal, with United Nations agencies and multiple partners playing a major role.
The GFF will build on the experience, capacity and strong track record of the Health Results Innovative Trust Fund at the World Bank Group to support developing countries’ national plans for scaling up access to quality reproductive, maternal, newborn, child and adolescent health services.  
Prime Minister Erna Solberg of Norway said, Norway is committed to support the Global Financing Facility. With its diversification of resources, results focus and targeting of girls and women, this is tailor- made for the new development agenda.”
 A unique aspect of the GFF is to support developing countries in their transition to long-term sustainable domestic financing as they grow from low- to middle-income economies. The facility is expected to mobilize additional domestic and international funds from a variety of sources, including other bilateral and multilateral donors, domestic budgets, the private sector and innovative financing mechanisms.
A special focus area of the GFF will be to support countries to expand Civil Registration and Vital Statistics (CRVS) efforts toward universal registration of every pregnancy, every birth and every death by 2030. CRVS systems provide a critical accountability tool for reducing mortality and ensuring universal access to health care, education and other essential services. 
Prime Minister Stephen Harper of Canada said, “I am very proud that Canada is a founding member of the Global Financing Facility for Every Woman Every Child. Canada believes that maternal, newborn and child health must stay at the forefront of the post 2015 agenda. Today's announcement will help ensure that developing countries have access to capital that will strengthen their health systems and build the necessary civil registration and vital statistics systems to record and track essential data, which saves the lives of mothers and children.”
Administrator Rajiv Shah, of the United States Agency for International Developmentsaid, “As we set our sights on achieving great human aspirations, we have to reimagine development with new business models, innovations, and partnerships. The Global Financing Facility will harness the creativity and expertise of a range of impressive new partners in order to save the lives of moms and kids everywhere. It is a symbol of a new model of development that increasingly defines how we work around the world to help end extreme poverty."
The MDGs have enabled remarkable shared progress toward ending preventable child and maternal deaths, but the job is not done,” said Ray Chambers, UN Special Envoy for Financing the Health MDGs and for Malaria. “I salute the World Bank, Norway, Canada, and the United States for this visionary and unprecedented collaboration to funding better health, and hope to see impact from this funding in the remaining 462 days of the MDGs.”
Consultations on the design and implementation of the GFF are now underway with countries and with key partners and organizations working on women’s and children’s health. The facility is expected to be fully operational in 2015.
We are delighted with this development,” said Dr. Margaret Chan, Director-General, World Health Organization. “In the last year we have estimated the investment needs for countries to end preventable maternal and child deaths by 2030 (an additional 5 US$ per capita per year in high-burden countries) and also to scale up CRVS plans. We are convinced we can work together so this facility will be the way to channel and leverage efficiently the funding needed to achieve these ambitious but realistic goals.
I welcome this initiative to support and increase national capacity to take leadership on financing women's and children’s health,” said Gra├ža Machel, Chair, The Partnership for Maternal, Newborn & Child Health. “PMNCH looks forward to facilitating wide consultation among its 650+ members from government and development partners, to civil society, academia, health professionals and the private sector to realize this vision.”

Thursday, September 25, 2014


Senfuka Samuel

Luyiga Faridah -Communications Officer at WRA Uganda speaking at PMNCH Accountability brunch-New York
The 69th Session of the UN General Assembly is convening in New York City from 16th September to 31st October 2014. It is convening at a time when the deadline to the Millennium Development Goals (MDGs) set in 2000 is remaining with less than 500 days. One of the agendas at this 69th session is that Governments around the world are sitting to reflect on delivery of their commitments to their citizens as they deliberate on new development targets beyond 2015. 

During this session, White Ribbon Alliance (WRA) for Safe Motherhood is working with other civil society advocates to ensure that global leaders do not talk to themselves alone but also give space and listen to what citizens want (citizens' voice) to be in the new Health Development Agenda. WRA's pressure exerted on the usual suspects (the familiar faces at UN top tables) to give up their speaking slots to citizens' voice yielded some results with appreciation. Ray Chambers, Special Envoy on Malaria to Secretary General of UN moved over for a citizen leader, Flavia Bustreo of WHO and Kathy Calvin of UNF gave up their seats to civil society leaders at the Every Women Every Child (EWEC) accountability     reception. Read about WRA Citizens Post-

Faridah Luyiga Mwanje of White Ribbon Alliance for Safe Motherhood Uganda was one of the civil society advocate for maternal health spoke on behalf of citizens at Partnership for Maternal Newborn and Child Health (PMNCH) brunch on the sidelines of UN General Assembly in New York. Faridah shared her personal story of losing a sister and her experience as a maternal health advocate which emotionally touched many attentive attendants.

"I thank the PMNCH for this rare opportunity to speak about the work we are doing- with families, with communities, with districts, with midwives, with politicians. Uganda still loses high number of women and newborns due to pregnancy and childbirth related causes. "My sister Remie Wamala bled to death. There was no blood to save her life. It's then that I realized if this level of neglect happens in a high end facility, what is birth like for most of my countrywomen? I joined White Ribbon Alliance where I am campaigning to make birth safe for women and newborns." Luyiga Faridah 
      Faridah reminded all of us that women should be treated with dignity while seeking healthcare with equity in health service delivery. "We should be cognizant of the fact that every woman has the right to quality, respectful, maternity care – and it is the role and responsibility of Govt to fund the provision of that care.
L-R: Dr. Robert C. Orr, UN Assistant Secretary General for Policy Coordination& Strategic Planning, Luyiga Faridah, Communications Officer WRA Uganda, Dr. Margaret Chan, Director General WHO and Richard Horton Editor-in-Chief of The Lancet 
      Government of Uganda Commitment to provide Emergency Obstetric and Newborn Care (EmONC)- Faridah said that despite Government's commitment to the UN Global Strategy for Women and Children's Health that half of health centres in Uganda would provide EmONC services, when WRA Uganda surveyed 43 health facilities in Kabale, Lira and Mityana districts it was found NOT ONE health facility (out of 12 health centre IVs) provided comprehensive EmONC- 

      "Our survey brought leaders together with district leaders, health workers and community members; for the first time they began to work together as partners, without fear of blame. I therefore implore you as global leaders and Governments to support the citizens who are working so hard to bring the change needed and wanted in their own countries." Luyiga Faridah

      #ActToSaveMothers #commit2deliver #MDGMomentum #UNGA2014

Friday, September 12, 2014

Govt Concerned About Power Blackout At A Football Match Not Life-Saving Health Centres

Senfuka Samuel

Where Are Our Country's Priorities? In #Uganda we have hundreds of health centres NOT connected at all to the National Power Grid. #Midwives are struggling daily to save thousands of women by delivering them using their cell phone torches and kerosene lamps- A health facility assessment conducted by White Ribbon Alliance Uganda in October 2013 found that out of 43 Govt health centres (IVs and IIIs) in Kabale, Lira and Mityana District, 24 of them were not connected to national power grid! Read full report

As Advocates for safer #pregnancy and #childbirth, therefore we are puzzled to read headlines in our local dailies and in some international media that police arrested, interrogated and charged the Namboole stadium manager with negligence because of a less than 10-minutes power blackout when our national football team was playing against Guinea on the evening of Tuesday 9th Sept. Also the power distribution company, #Umeme immediately issued a statement about the incident that it was due to fluctuation in electricity supply. See

We all agree that there should not be power failure at such an international game but we have not seen same action(s) by Uganda Police or other Govt agencies strongly coming out to ASK WHY our health centres are operating in darkness or even arrest those responsible to connect them to electricity because this is a matter of LIFE and DEATH!

Our Govt should rethink about our priorities. We ask our Govt  to ACT urgently to FULFILL the commitments made to secure women's and children's health. Availability of electricity is essential in provision of life saving health services especially to pregnant women and their newborns.

#ActNowToSaveMothers #commit2deliver #MDGMomentum  #EveryNewbornCounts

Saturday, August 23, 2014

Marking 500 Days to MDGs Deadline: Citizens Reflect on Accountability Work for Improving Maternal Health

Compiled by Senfuka Samuel with Citizen Journalists Rose Nalugo and  Kaddu William

Kaddu William a Citizen Journalist trained by WRA
Many Civil Society groups do a lot of work but  fail to report back to the stakeholders involved in the initiatives due to weak accountability mechanisms. It's vital to plan and integrate accountability mechanisms in all people-centred initiatives. To be accountable to its stakeholders, White Ribbon Alliance for Safe Motherhood Uganda members in Mityana convened a meeting on 22nd August 2014 to share successes, challenges and lessons learnt from Act Now To Save Mothers campaign implementation. The campaign that was started in October 2013 in the district focuses on pushing Government to fulfill its commitment of providing C-section and blood transfusion services (comprehensive emergency obstetric and newborn care) at health centres IV and basic emergency obstetric and newborn care in all health centres by 2015 . The meeting was attended by district political leaders, District Health Team members, community members, health workers among others.

Sr Esther Kalule speaking to stakeholders at Enro Hotel
Mityana District residents were stricken by sad news of losing ten (10) women in childbirth between January &August 2014. This was revealed by Mityana District Principal Nursing Officer Sr. Esther Kalule at the meeting.  "It's sad to reveal to you that we have lost 10 women between January and August 2014 at the district hospital. Majority of them died due to delays at home, at health centres, poor emergency transport means and by the time they reached hospital they could not be saved." Kalule said. Sr Kalule a midwife called on to White Ribbon Alliance to speed and scale up community social accountability so that linkages among community, health workers and leaders  are strengthened to save lives. "This meeting to give feedback has been an eye opener and a challenge to all of us. I did not know that Government had finally increased our salary and by what percentage but through this feedback meeting am able to get the information," Sr Kalule expressed. According to Sr. Kalule Mityana District Hospital alone delivers an average of 400 women per month of which an average of 100 deliver by cesarean section.

Dr Lwassa making a presentation on district health budget at Enro hotel
Mityana District Health Officer Dr Lwassa in his presentation of the budget for financial year 2014/15 indicated an increment of wages for health workers aimed at motivation & retention. "Our wage bill has increased from shs 3.4 billion in 2013/14 to 5.3 billion in 2014/15. We have also allocated shs 166,000,000 million to improve on staff accommodation which is anticipated to reduce on staff absenteeism." He added

Mr. Bukule presenting on medicines and supplies 2014/15
"We have made great progress since the medicines meeting convened by White Ribbon Alliance in February 2014. We have ensured that life-saving medicines& health supplies are adequately planned for in this FY 2014/15. The remaining challenge is for our In-charges to make timely orders but also National Medical Stores to honor& supply what we request for," District Medicines Management Supervisor. A        budget of Shs 1.2 billion was allocated to the district to procure medicines and health supplies.

Mr. Lubega Israel District Vice Chairperson speaking at stakeholders review meeting
"On behalf of the District leadership, I pledge  our support and continued partnership  with White Ribbon Alliance in improving women's health. We are ready to work together and the community members to ensure that funds allocated to deliver maternal health services are well utilized," District Vice Chairperson committed

Group Discussion led by Chairperson Health Unit Management Committee Naama HC III
Senfuka Samuel giving feedback to stakeholders on national budget proposals 
Group led by Sr Kalule Principal Nursing Officer

Thursday, July 24, 2014

Health rights activists and MPs outline health budget priorities


Posted  Thursday, July 24  2014 at  10:37
The total allocation to local governments is Shs323.145 billion compared to Shs575.4 billion reserved for the Ministry of Health headquarters.

Civil society health rights organisations and law makers have identified key areas where they want government to direct more funding ahead of today’s meeting with the ministry of Health aimed at scrutinising budget allocations to the health sector.
In a joint meeting Wednesday, the legislators on the Parliamentary Health Committee concurred with health rights activists of the White Ribbon Alliance (WRA), Initiative for Social and Economic Rights and the Civil Society Budget Advocacy Group (CSBAG) agreed to push for increased funding to the Primary Health Care (PHC), maternal health and enhancing salaries of health workers.
“We as a committee have agreed to prioritise the recruitment of health workers. We shall also demand for answers on allocations to the Primary Health Care and why this area has been marginalised over time,” said the Mbarara Municipality MP, Dr Medard Bitekyerezo, while chairing the meeting.
This was after a submission by members of civil society who stressed that without paying special focus on ensuring an adequate human resource and primary health care funding especially at the various health centres, the health sector would remain crippled which could among others problems, accelerate maternal deaths.
“The dilemma is that government has approved a constant sum of Shs 15billion for Health centre 111s and Health Centres 1Vs countrywide but to us this is peanuts. Most women have died as a result of health workers lacking simple essentials like gloves, fuel for ambulances and lack of electricity as a result of failure to pay exorbitant Bills. Government must direct more funding in this field,” said Ms Robinah Biteyi, the executive director of WRA.
Ms Angella Nabwowe, the Programme Coordinator for Initiative for Social and Economic Rights and a member of CSBAG pointed out that Parliament in 2011 passed a resolution compelling the ministry of Health to submit to Parliament annual reports on maternal audits as a way of curbing maternal deaths and the ministry has never responded to their demand.
She identified the monitoring and evaluation slot in this financial year’s budget arguing that it has remained underfunded.
“The objectives of this according to the Ministerial Policy Statement is to conduct regular health sector performance, monitoring and evaluation, to ensure that standards and guidelines are developed, disseminated and used effectively at all levels. It is also to ensure that a regular support supervision system is established and strengthened at all levels among others”, she said.
In the Ministerial policy statement for the financial year 2014/2015, it is stated that only Shs41 billion  has been allocated as recurrent budget to run health service delivery in 137 local governments with 56 general Hospitals, 61 Private Not For Profit Hospitals and 4,205 lower health units for the last five years.
The total allocation to local governments is Shs323.145 billion compared to Shs575.4 billion reserved for the Ministry of Health headquarters.
“Concentrating resources at the national level is problematic since most people use the public health care system at local government level. Stagnation of this budget line amidst the ever increasing prices of goods and services, including utilities makes the running of health facilities difficult,” Ms Nabwowe said.
PHC budget involves buying hospital equipment that is used on day today activities, clearing the hospital’s electricity and water bills, maintaining the hygiene of the hospital and running ambulances.
While the primary school teachers are getting a 25percent salary increment as announced by the Finance Minister, Ms Maria Kiwanuka in this year’s budget, health workers will benefit from an overall Shs450 billion salary increment for all public servants in the country.
Midwives earn less than Shs350,000 monthly plus a Shs12,000 overtime allowance which the activists said is very little.
The ministry expressed the need to recruit 2400 health workers requiring an additional 23.4billion in wages. But going by the wage bill, the funds were not provided. The Health ministry, however, indicated in the 2014/2015 financial year that it can only recruit through the Health Service Commission an extra 800 health workers for as long as the money is availed.

Wednesday, July 16, 2014

Women MPs Want More Funding for Childbirth


Posted  Wednesday, July 16  2014 at  01:00
Two women representatives want Parliament to push the Executive to allocate more funds to obstetrics – a branch of medicine that deals with childbirth as well as midwifery.
They say the amount the government has been allocating has compromised childbirth so much so that less than 40 per cent of the health centres have piped water in the maternity wards.
“This has compromised clean and safe births, which increases the risk of infections that currently account for about 22 per cent of maternal deaths in the country,” Ms Ronah Rita Ninsiima, the Kabale District Woman Representative, said on Tuesday when reading a petition by women from Kabale.
She added that many health centres could not carry out caesarean sections and transfuse blood.
Relatedly, Ms Joy Atim Ongom, the Woman Representative of Lira District, said the government should meet “new-borns care services”.
The women leader’s pleas – during yesterday’s plenary – come just weeks before the House starts appropriating money for the different government departments, one of which is the Ministry of Health.
Ms Rebecca Kadaga, the Speaker of Parliament, referred the petitions to the House Committee on Health.
The committee should scrutinise the petitions, hear from stakeholders, make recommendations and report back to the House within 45 days.
However, in many cases, many a committee of Parliament do not complete the work within the 45 days.
Consequently, the people who would have rushed to Parliament for assistance assume the House has ignored their problem.
Dr Chris Baryomunsi, the Member of Parliament of Kinkiizi East, said the House should consider whether it should form a special committee to handle petitions.
The Speaker said this could be because some petitions are supposed to be dealt with by some government committees.