Tuesday, January 25, 2011

Skilled Birth Attendance Saves Kyomugisha

Skilled attendance to counteract maternal, neonatal deaths has proved effective as Sarah Kyomugisha and her baby get saved.
On the night 12th January 2011, Sarah a pregnant mother starts feeling mild contractions and she gets terrified. Being a safe motherhood advocate she knows what to do, and early morning the next day, she visits Kabale referral Hospital for skilled advice. Here, the doctor informs her that the baby is lying transverse.
Sarah tells us verbatim:

A joyful Sarah with her newborn in labor war, Kabale Hospital
“It was on the night of 11th Jan 2011 when I started feeling mild contractions the following morning on 12th Jan 2011, I went to Kabale referral Hospital where I saw the Doctor, and he palpated me the baby was lying transverse.
Having previously had my first born by C-Section at weeks due to preeclampsia I feared developing the same and also risking my baby by waiting for it to turn. I then decided with my Doctor to have an elective C-section at 1:00pm, I entered Theatre all dressed with my badge for safe motherhood on my gown ready to have my baby and I watched as my baby came and was blessed with a baby boy we named Nkurunziza (good news) Surya. I am now very fine and recovering with God's hand upon me.
Everyday throughout my pregnancy my husband and I always wore the badges promoting Safe motherhood”.

She urges that it’s every ones responsibility to educate the women to always attend Antenatal clinics for skilled assistance.
“I think it’s ‘everyone’s’ responsibility to educate the women to always attend Antenatal clinics and also know their bodies to rush to hospitals for help when need arises”.

She is appreciative for having been introduced to WRA in the promotion of safe motherhood. Her being a safe motherhood advocate could be the reason why her husband is safe motherhood literate; for she took care of her from the early stage of pregnancy as Sarah tells us. She continues to extend her gratitude:
“I thank my husband too for the care; he attended Antenatal clinics with me and when you attend with a man you are given first priority and he got to know what I was going through.

One can imagine, what would happen if Sarah had visited a traditional birth attendant! Again think; what if she had reached the hospital and there was no doctor or a delay!
Now you are aware of what pregnant mothers of Kyankwanzi District (North West of the capital city) go through. Over eighty (80) mothers visit Ntwetwe Health Center IV monthly, (the only big healthy facility in the area) but with limited essential facilities, most importantly the man power-there is only one aged mid-wife to attend to all that number! The center has only two (2) delivery beds and the drugs are inadequate.
The antenatal checkup is only done twice during pregnancy. This propels the mid-wife make a number of referrals to Kiboga Referral Hospital located in the nearby district which many mothers say it’s very far; they can’t reach amid poor transport network and poverty. When it comes to husbands taking care of their wives, it is worse. This is exacerbated by unpreparedness at home.

Asked what happens when they are referred to Kiboga Hospital, the mid-wife expresses concern:
“When I refer them to Kiboga, they do not go there. They just go to Traditional birth attendant, infact many mothers have lost their lives”. She laments.
This situation is not only in Kyankwanzi, in Karamoja-northern Uganda, there is only one midwife and no doctor in the whole district as we are reliably informed by our members in the north.

 A lot is lacking; there is need to increase our momentum on advocacy, resource mobilization and holding leaders accountable in order to catalyze action for safe motherhood. The death of 16 women in Uganda is shocking.
We need all women to give good news as Sarah Kyomugisha.

Elman Nsinda
WRA Uganda member

Friday, January 21, 2011

No Woman Should Die While Giving Life: A Call to Action

By Dr. Nakachwa Irene 
Member of WRA Uganda

Dr Nakachwa Irene addressing the community at Nyendo-Senyange Health
Centre II, Masaka  during East African Caravan July 2010.
 Motherhood is supposed to be a period of joy, and yet for many in developing countries it is a period of mixed expectations with a high risk of death of the mother, newborn baby or both. In Uganda currently, at least one woman dies everyday from a pregnancy or delivery related complication. For every 100,000 live babies born every year approximately 435 mothers and 2900 newborn babies die1.

Of specific concern is the high number of maternal deaths[1] occurring in the health facilities most of which could have been prevented. Although late presentation of clients to health facilities is undoubtedly a contributing factor, substandard case management at the health facilities is potentially an overriding determinant. This therefore implies that, while improving geographical access to institutional deliveries and Emergence Obstetric Care (EmOC) is important; a focus on the quality of case management at the already existent facilities is the more urgent.

Policy makers should target improving the behavior of providers through malpractice litigation, professional oversight, enforcing countrywide use of national clinical guidelines and protocols, targeted education and professional retraining, staff motivation as well as ensuring availability of basic supplies. Quick access to EmOC facilities should be improved by accelerating the functionality of existent health centre IVs, and increasing community participation in maternal care.

[1] Maternal death: death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by pregnancy or its management but not accidental or incidental causes. (WHO, 1999)