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| 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
bsenfuka@gmail.com/info@wrauganda.org
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.
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| 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.
It's equally important that strong accountability mechanisms should exist and put to function to ensure proper utilization of allocated funds.
It's equally important that strong accountability mechanisms should exist and put to function to ensure proper utilization of allocated funds.
#ActNowToSaveMothers
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