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.


Thursday, January 2, 2014

Lira health centres rely on rain water – WRA Study

By Patrick OkinoPublish Date: Dec 22, 2013

Serious water and power shortages in health facilities present a massive problem in labor wards in Lira district, where birth attendants are forced to use phones and lamps at night during the process of child delivery.

A study by White Ribbon Alliance (WRA), an NGO, found that health facilities rely on water from the wells, boreholes and also rain water.

Among the health centres involved in the survey were Bar, Aromo, Amach, Agali, Ongica, Barapwo and Ober in Lira.

The report revealed that none of the health centres involved in the study had running water, a huge constraint to the flow of activity in the centres.

Absence of piped water therefore means infection control is greatly constrained.

In five out of the nine health centres surveyed, workers reported using personal mobile phone torches as backup for lighting during delivery of mothers at night.

Two birth attendants said they used hurricane lamps and three admitted they had no form of power backup.

The project manager, Senfuka Samuel presented the report to Lira regional referral hospital at the close of this week.

Lira district speaker, Ocen Odyek, LC3 chairpersons, sub-county chiefs, district councilors and health workers attended the presentation of the report.

Six of the health facilities harvest rain water for regular use, seven use boreholes while others rely on wells or hire people to collect water for them, revealed the report.

One midwife from Bar health centre, Betty Akullo said they risk getting infections any time because of shortage of water in the delivery ward.

Acute shortage of water and power at the lower levels is putting more pressure on the referral units.

Senior principal nursing officer at Lira regional referral hospital, Petrua Kiboko says patients are overwhelming referral units in the region because of the problems at the health centres.

The main hospital too runs out of the power sometimes, and has to use generators as backup, with a consumption of about 24 litres per hour.

Friday, December 13, 2013


Patrick Ogwang
WRA Uganda (WRA Lira District Media Coordinator)

Tommy Ojan Egits presenting the petition at Amach Sub-county headquarters 
during  Lira District World AIDS  Day commemoration 
White Ribbon alliance Lira in collaboration with residents from the two sub county of Ogur and Amach petitioned Lira District Local Government to allocate a budget in the financial year 2014-2015 to support Emergency obstetric and newborn care services at health center s III and IV. The petition signed by over 1000 community members was presented to the District Council through the District Speaker.
While handing over the petition to the district leaders at the commemoration of World Aids Day district event at Amach sub county headquarter, Tommy Ojan Egit who is a WRA Lira member and newly elected representative at the WRA Uganda board said that the petition followed an assessment by White Ribbon Alliance, leaders and community members carried out in all the health facilities at level of III and IV in Lira with the indicator that none of the two HC IVs is able to provide comprehensive emergency obstetric and newborn care services due to theater functionality issues.
Ojan further stressed that shortage of running water, power and non-functional theaters at Ogur and Amach HC IVs, stock-outs of injectable drugs for basic obstetric complications, inadequate resuscitation devices, lack of blood pressure machines and incomplete delivery instruments among others has put the lives of pregnant women and their newborns at risk since most of them are referred to the main regional referral hospital which is far away from them.
Tommy Ojan Egits handing-over EmONC petition to Lira District 
Vice Chairperson at Amach Sub-county headquarters
“The petition requested the district officials to allocate sufficient funds for emergency care services in the financial year 2014-2015 in an attempt to reduce the death rate of women in childbirth. The White Ribbon Alliance is not an NGO but Alliance whose aims are to advocate for safe motherhood.” Said Tommy

Mr. Andrew Ogwang Oyang the District Vice Chairman and the leader of government while receiving the petition on behalf of the District Speaker and the council thanked The White Ribbon Alliance for their effort of carrying out an assessment saying it has helped a lot the district to get documented information for planning. The Chairperson promised to handle the petition with urgency it deserves so that the issues raised are considered in the district budget.
Subsequently, on 6th December 2013, The White Ribbon Alliance members held a meeting with the members of the district committee for health and education to further advocate for prioritization of emergency obstetric care services in the district budget. Mr. Moses Ogwang Adonyo the Chairperson of health and education committee said that his committee will make sure the report findings are brought to council for further scrutiny and approval so that a budget is allocated in the financial year 2014-2015.

WRA Lira and community members march during World AIDS Day commemoration
event at Amach Sub-county headquarters, Lira 
district before presenting their petition
The petition is part of a series of activities under the accountability campaign code named ACT NOW TO SAVE MOTHERS coordinated by The White Ribbon Alliance Uganda in three districts of Lira, Mityana and Kabale aimed at asking Government of Uganda to uphold its commitment of increasing comprehensive emergency obstetric and newborn care in all health centres IV from 17% to 50% and ensuring that basic  emergency obstetric and newborn care is available in all health centres before its target timeline of 2015. #ActNowToSaveMothers

Monday, December 2, 2013

White Ribbon Alliance Members in Kabale Petition District Speaker over Low Status of Emergency Obstetric Care in the District

Members pose for a photo after presenting and handover a petition to Hon. Twinomuhangi Pastoli, Kabale District Council Speaker at his office.

By Robert Muhereza
WRA Kigezi, Media coordinator

Today December 2, 2013 White Ribbon Alliance Uganda-Kabale district and community members joined by district councilors petitioned the District Speaker Hon. Twinomuhangi Pastoli on the LOW STATUS OF EMERGENCY OBSTETRIC AND NEWBORN CARE SERVICES IN KABALE HEALTH CENTRES IV AND III. After the damning findings of the health facility assessment of emergency obstetric care status conducted by White Ribbon Alliance, District Health Office, community members and leaders, members are asking their district council and leadership to prioritize funding for EmONC in FY 2014/15.  The Speaker pledged to table the petition before the district council for discussion and consideration of the issues contained in the petition.

Members will meet the district Standing Committee of Health to discuss further and advocate for prioritization of making theaters at HC IVs function. All the 7 health centre IVs of Kabale do not provide C-sections and blood transfusion due to lack of medical officers. 

Join WRA advocacy campaign in Kabale to Save the lives of many pregant women in Kabale- #ActNowToSaveMothers 

Thursday, November 28, 2013

Accessing Services at Ogur Health Centre IV: A Journey into Hell!

For our esteemed visitors and readers of this blog page, Bill Oketch a Journalist based in Lango sub region treats you to yet another article about the status of life saving services at Ogur HC IV, Lira district. 
I hope those who understand Luo it will be provoking, insightful and swing you into a discussion and action.