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.
Of specific concern is the high number of maternal deaths 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.
 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)