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.

Friday, March 7, 2014

Equality For Women Is Progress For All: Access To Life Saving Services for Pregnant Women Is A Matter of Fairness and Right

Senfuka Samuel

A Book Cover of Becoming A Mother
Traditionally, every 8th March the world celebrates women in recognition of the pivotal role they play in various spheres of development. Women are the mothers of the world, they risk and carry a pregnancy for full nine months and go through the pains of childbirth. Women also nurture us.

Despite the risk associated with pregnancy and the labour pains they go through, pregnancy and childbirth are celebrated around the world. As part of this year's International Women's Day celebration, Ms Brigid McConville-Media Director at White Ribbon Alliance for Safe Motherhood has collected all these wonderful experiences of pregnancy and childbirth around the world including ‪#‎Uganda‬ in a new book ‪#‎BecomingaMother‬A copy of this wonderful book can be ordered at:

In line with UN theme for 2014 IWD "Equality for Women is Progress for All," proceeds from the book (Becoming a Mother) will support the White Ribbon Alliance for Safe Motherhood work towards making pregnancy and childbirth safer for all women regardless of where they live, social or income status.

This year's IWD celebration is aimed at highlighting the importance of achieving equality for women. White Ribbon Alliance for Safe Motherhood Uganda highly considers access to life-saving care services for all pregnant women and newborns as a matter of fairness, a right to healthcare and life.

We call on our government and leaders for more action to accelerate progress towards improving maternal health (MDG5) more especially to ensure that comprehensive emergency obstetric and newborn care (CEmONC) increases in health centres IV from 17% to 50% and that basic emergency obstetric and newborn care services are available in all health centres to avert maternal and neonatal deaths as you promised.

The Time is NOW, the DEADLINE for MDGs is Next Year (2015) #ActNowToSaveMothers

Happy International Women's Day celebrations!

Friday, February 14, 2014


Sr. Doreen a midwife at Lira Regional Referral Hospital showing a new mother (seated on bed) how to take care of a newborn baby. Photo taken by Senfuka Samuel during a health facility assessment of EmONC at Aromo HC III, October 2013
Senfuka Samuel
WRA Uganda

Management of pregnancy and labour is vital for the survival of a pregnant woman and her unborn baby or newborn. This requires a functional health system to meet the needs of both a pregnant woman and the baby. The system should have emergency life-saving medicines; well trained and motivated health workers like midwives, doctors and theater staff; functional theater to conduct caesarean sections and safe blood transfusions; sufficient supplies and necessary equipment among others.

During a meeting on 13th February 2014 convened by White Ribbon Alliance for Safe Motherhood Uganda (WRA Uganda) with Lira district medicines and health supplies procurement and management team headed by the District Health Officer, it was disclosed that in the 1st and 2nd quarter of FY 2013/14, the district officially conducted 5,139 deliveries. However, over the same period of time the district recorded 6 maternal deaths and 184 neonatal deaths of which over 80% were stillbirths (both fresh and macerated)! These deaths go on quietly yet many of them would have been averted if the Government boldly allocated sufficient funds to fulfill its commitment to fully equip Health Centres III and IV with sufficient medicines and supplies for Antenatal Care (focused ANC); Emergency Obstetric and Newborn care (EmONC) medicines and supplies; motivated health workers and the tools they need to provide effective emergency care. 

In October 2013, WRA Uganda together with the District Health Officer (DHO) and his team, leaders and community members conducted a health facility assessment in all the nine (9) government health centres in the district to establish the status of emergency obstetric and newborn care services and the findings correlate well with the maternal and neonatal situation in the district.  As a result and willingness to change the ugly maternal and neonatal situation in Lira, the DHO has made a decision and proposed an allocation of Ushs. 100,000,000 million to renovate the only two theaters at Ogur and Amach HC IVs in FY 2014/2015 so that pregnant women who face obstetric complications can be saved.

To further show his willingness to improve maternal and newborn health, the DHO pledged to prioritize the funds for procurement of equipment in FY 2014/2015 based on the gaps identified during the health facility assessment. This pledge was made during a meeting with district medicines and supplies procurement and management team convened by WRA Uganda and its members in Lira district under “ACT NOW TO SAVE MOTHERS” Campaign. The purpose of the meeting was to discuss the prioritization of essential medicines, supplies and equipment for EmONC in the district procurement plan in FY 2014/2015.

A section of members of Lira district medicines and health supplies procurement and management team chaired by Assistant DHO (MCH) during a group work session (Group One) on developing a procurement plan. Photo taken by Senfuka Samuel during the meeting at Lira district 

According to the WRA Uganda EmONC health facility assessment report only 3 out of 9 health centres had resuscitation devices for the newborns making it difficult for midwives to resuscitate babies with breathing complications at birth. Only 4 out of 9 health centres had blood pressure machines despite the fact that high blood pressure is one of the direct causes of maternal deaths in Uganda contributing about 6%. Only 4 out of 9 health centres had a complete delivery instrument set making management of delivery complicated. In addition all the 9 facilities were found with no running/piped water in their maternity undermining safe and clean births.

According to National Medical Stores an authority mandated to procure and distribute medicines and supplies for all government health centres, Ushs. 3,600,000 and 10,000,000 is allocated to HC IIIs and IVs respectively for medicines and supplies for a period of two months. Districts experience stock-outs of some medicines and supplies partly due to the limited budget in which they operate vis-à-vis the actual demand. This calls for regular review of the budget allocations to reflect the needs and demand from local governments. Ministry of health needs to popularize the newly adopted medicines like misoprostol, chlorhexidine for disinfecting newborn cords etc at the district level health service providers. 

The current maternal and neonatal health situation in Lira gives us a glimpse of what may be happening in other parts of the country. The recently launched Reproductive, Maternal, Newborn and Child Health (RMNCH) Sharpened Plan (2013-2017) by ministry of health in November 2013 identified labor and delivery management as doable evidence based high impact intervention to reduce both maternal and child mortality by averting or saving 4,262 and 13,533 maternal and child deaths respectively over the plan’s time-frame.  This  therefore requires our health centres to be with readily available and accessible basic and comprehensive emergency obstetric and newborn care services to meet such targets. If we are  to walk the talk, ministry of health should therefore request ministry of finance to allocate sufficient funds so that such priorities are reflected in the budget allocations which eventually trickles down to districts for delivery of health services. 
It's equally important that strong accountability mechanisms should exist and put to function to ensure proper utilization of allocated funds.