Health Minister Reassures Medical Workers of Improved Welfare

 Minister of Health-General Duties Hon Dr Chris Baryomunsi (on podium) addressing members of White Ribbon Alliance  Uganda during the Annual General Members' Meeting at Statistics House, Kampala

By Njaleruma Kigozi,

Citizen Journalist, 

The White Ribbon Alliance Uganda

Buikwe District

State Minister for Health General Duties, Dr. Chris Baryomunsi reaffirmed the Uganda Government’s commitment to improve the welfare of medical workers in the country.

Baryomunsi was addressing members of White Ribbon Alliance Uganda (WRA- Ug)—a non government organization, advocating for safe motherhood and a nation free of newborns deaths, at its Annual General Meeting (AGM) at Statistics House in Kampala on Friday 27^th March, 2015.

Baryomunsi, who was the Guest of Honour at the event, said that an increase in negligence of duty and carelessness by medical workers in government health centers and hospitals across the country has been identified as a major cause of loss of lives, mostly of pregnant mothers and newborns during pregnancy and birth.

He said that such a situation has been blamed on the usual complaints that medical workers in the country get little pay and a raw deal from the central government that employs them, compared to their counterparts in other countries where their services are equally needed. “They can only be held responsible in terms of service delivery to the pregnant mothers and other citizens in the country only when the people who handle life at our health centers enjoy a better pay and a competitive welfare” he added.

Knowing very well that childbirth is still a death trap in Uganda, claiming the lives of 17 women and 106 newborns every day, the Minister said that the problem can only be partly tackled by improving the welfare of government workers, including medical workers, and that they are prepared to fulfill this obligation.

Baryomunsi also revealed that his ministry was in preparation to send senior officials to health centers around the country to reassure medical workers that the central government has big plans in store for them, particularly in improving their working conditions. This is aimed at changing their attitude towards work.

The White Ribbon Alliance Board of Directors Chairperson Mr. Obed Kabanda told the gathering that WRA-Ug has dedicated a dynamic advocacy campaign, “Act Now to Save Mothers,” to hold the government accountable to its commitment to ensure that women have access to life-saving care.

He emphasized the need for the central government to provide Emergency Obstetric and Newborn Care (EmONC).  “Take this as a priority intervention to reduce maternal and newborns deaths in Uganda,” Kabanda said.

Lira District Woman Member of Parliament, Hon. Joy Atim Ongom, who also attended the AGM, strongly attacked men in her area of jurisdiction who spend money and time in bars drinking alcohol, whilst women they make pregnant are languishing with the pregnancies in their households with little or no financial help and care. She called them irresponsible husbands.

L-R: Lira District Woman MP-Hon Joy Atim Ongom, Hon Dr Chris Baryomunsi-Minister of Health (General Duties) and Mr. Obed Kabanda-Chairperson BoD White Ribbon Alliance Uganda

“Some men in Lira, like in any other district in Uganda, not only neglect their pregnant wives during pregnancy and at the time of delivery but go on to mount them forcefully at night for sex even when they are not in the mood,” Hon. Atim said and added that such occurrences add salt to the already dangerous wound/ situations pregnant mothers are going through. She called on men to be responsible and take lead in saving the lives of women they impregnate.

Ms Robinah Biteyi, the National Coordinator WRA-Ug reminded the gathering that women and newborns die from preventable and treatable complications that include, severe breeding (heamorrhage), infection (sepsis), eclampsia (high blood pressure), obstructed labor, unsafe abortions and asphyxias. She added that the causes are worsened by lack of or inadequate emergency obstetric and newborns care equipment/device, medicine and health supplies, skilled staff, especially with midwifery skills and resources necessary to provide quality life saving care in order to reduce maternal and newborn mortality.

“Those are the things the government can provide in time without being hoaxed or pressurized if our mothers and newborns can see light even for another day,” Biteyi said.

She suggested that the government should ensure that there are more health centre IIIs and IVs providing Emergency Obstetric and Newborn Care (EmONC) and more health center IIIs and IVs with adequate medicine, health supplies, equipment and skilled staff to provide EmONC services. She added that community members should demand EMONC at HC IIIs and IVs, more women should be delivering at health centers and that there should strong linkages between the formal health system and the community. Biteyi said the government should involve citizens in setting their health priorities.

In her closing remarks, the Woman Member of Parliament for Kabale District Hon. Rhona Ninsiima reminded the people of Uganda to hold the government accountable to its commitment to ensure that women have access to life saving care. She called on citizens to always sign petitions asking on their members of Parliament, district and sub county leaders to allocate sufficient funds to provide medicines, health supplies, equipment and skilled staff to save the lives of pregnant women and newborns at their local health centers.

The participants at the AGM asked the government to provide a motivation package for health workers and to functionalize operating theatres by allocating sufficient funds to renovate and equip them.

Email: communityhealthinitiativeprogram@yahoo.com

Shs225 million needed for resuscitation machines

A set of the device contains an ambu bag (neonatal bag) and mask used to blow air into the lungs; suction bulb for sucking out the mucus and a training mannequin to be used to train health workers on the procedure

By Sandra Janet Birungi

Posted  Thursday, March 26  2015 at  02:00

Kampala. A total of Shs225m is needed to buy resuscitation devices used to suck out mucus from lungs in newborn babies to enable them breathe and survive thereafter.

The failure to breathe at birth, known as birth asphyxia, is one of the leading causes of child mortality and can be prevented by use of resuscitation devices. The device costs about Shs300,000, according to Mr Moses Kamabare, the executive director of National Medical Stores (NMS).
“If we are to go by the 2013 study conducted by White Ribbon Alliance in the districts of Lira, Mityana and Kabale, on average, 20 machines are needed per district. With 112 districts, we would need 750 machines; and with each machine costing about Shs300,000, we would need Shs225m to buy them, which is not expensive,” he said.

Dr Jesca Nsungwa Sabiiti says one in every 10 children born needs resuscitation at birth, accounting for 106 deaths every year or 26 per cent of the neonatal deaths in the country. She adds that if these deaths are not addressed, child mortality will not be reduced.
“Most deaths in children are preventable and one of the ways of preventing them is through the use of these devices; they should be distributed to health centres together with the drugs from NMS. But for them to be made available, districts have to request for them such that the ministry can undertake the exercise to purchase and distribute them countrywide, he said adding: “It is also important to purchase the right devices which can easily be used at the health centers.” 

To ensure that health centre IIIs and IVs across the country get these devices, Dr Anthony Mbonye, the commissioner for community health services at the Ministry of Health issued a directive to NMS to include the purchase of the devices.

Ms Robina Riteyi, the national coordinator of White Ribbon Alliance, said this will be a more sustainable form of ensuring they are available for use at the different health centres.

jbirungi@ug.nationmedia.com

Source: http://www.monitor.co.ug/News/National/-million--needed-resuscitation-machines/-/688334/2665536/-/uihcsoz/-/index.html

The General Manager National Medical Stores Moses Kamabare chats with Commission Clinical Services Dr Jacinto Amandua after the policy feedback meeting at Mackinnon Suites

L-R: WRA-Ug National Coordinator Robina Biteyi, AMREF Project Coordinator on UN Life Saving Commodities Dr. Stephen Ayella and Asst Commissioner MoH Dr Jesca Nsungwa during a policy feedback meeting organized by White Ribbon Alliance at Mackinnon Suites

White Ribbon Alliance Senfuka Samuel consulting National Medical Stores Board Member Ms Sarah Nyombi (R) and The General Manager Mr Moses Kamabare at the meeting 

Members Decry Poor Medical Services in Lira

MPs, Chief Administrative Officer Lira District and WRA Lira members in maternity ward at one of the health centres visited 

Source: Parliament of Uganda Website- http://www.parliament.go.ug/new/index.php/about-parliament/parliamentary-news/534-members-decry-poor-medical-services-in-lira

Members on the Parliament Committee on Health were shocked when they realized that all the theaters in health center III and IVs in Lira district are dilapidated and non-functional. This was during  the committee’s  fact finding field visit to Lira health facilities following a petition to Parliament on the low status of life-saving emergency services for pregnant women and newborns by the community of Lira district. The petition was laid on table by Lira district woman Member of Parliament Hon. Joy Atim Ongom on 15th July 2014. 

The committee was amazed to discover  that the accommodation facilities at the health centre III and IVs were abandoned and no single health worker was present  at Anyangatir and Barapwo Health Centre III. Lira District Health Officer Dr. Kusolo Peter noted that as a result, patients prefer to go to Lira Regional Referral Hospital which has led to over congestion in the hospital especially the labor ward. 

Hon. Lematia Ruth who is the Vice Chairperson of the Parliament Health Committee noted that  Uganda can prevent maternal and newly born deaths by ensuring that  women have immediate access to basic and comprehensive life-saving emergency services in the health Centers.  She stressed that  99 percent of all maternal deaths are preventable since the causes are known.  She added that the continuous death of women and their newborns is a sad reminder that Uganda  not doing enough to prevent the death of women during pregnancy and childbirth.

Lira district woman Member of Parliament Hon. Joy Atim Ongom who is also a member of the committee noted that government has to ensure that enough funds are budgeted to improve on the infrastructure and employ qualified health workers in all health centres. She urged women, husbands, families and the community, to involve themselves in maternal health issues so that women feel safe while giving birth to life.

Hon. Dr Twa-twa Jeremiah holding and checking a maternity register joined by other MPs and WRA Lira Chairperson (in navy blue midwifery/nursing uniform) at Ogur health centre IV. Photo by Denis Okwir-WRA-Ug Trained Citizen Journalist

Graft claims hit Uganda medic export scheme

Medical staff at the Butabika National Referral Hospital in Uganda. PHOTO | FILE |  NATION MEDIA GROUP

By Julius Barigaba

Even as Ugandans await a ruling on the temporary injunction to stop the government exporting over 250 health workers to Trinidad and Tobago, it has emerged that the recruitment was riddled with corruption.

Amid reports that unqualified people paid up to Ush7 million ($2,456) to be shortlisted, Kampala became wary of a backlash from the Trinidad and Tobago government. It placed advertisements in the media to isolate people cited in bribery claims ahead of a thorough screening of the shortlisted workers.

Last August, the Ministry of Foreign Affairs shortlisted 450 doctors, nurses and midwives drawn mainly from public health institutions to be exported to Trinidad and Tobago on three-year contracts. Sources say officials from the Caribbean island nation will travel to Kampala “anytime soon” to help with the selection of the final 263 health workers who have the required skills. 

READ: Plan to export medical staff to Trinidad lands Uganda govt in court

A source familiar with the recruitment told The EastAfrican that, among this number, there are unqualified people who bribed their way into the shortlist. 

“People who are not qualified doctors or health workers paid to get shortlisted,” the source claimed. “Are you surprised? This is Uganda.”

‘No bribery’

But Foreign Affairs Ministry spokesman Fred Opolot said if indeed the claims are true, the victims should come forward and name the perpetrators of the fraud.

“We ran adverts and said that people making these allegations should come to the Ministry of Foreign Affairs and the police and file official complaints but no one has come forward,” said Mr Opolot. “As far as we are concerned, we don’t know of any bribery in this exercise.”

In November last year, The EastAfrican reported that the Institute of Public Policy Research (IPPR) had sued the Attorney-General, seeking to block medical worker exports to the Caribbeans by the Foreign Affairs Ministry.

The High Court will rule on March 2 on the case, in which IRRP’s lawyer, Justinian Kateera, argues that “besides being contrary to public health policy it is also unethical, irrational and unconstitutional for Uganda to deny its own citizens the much-needed health workers.”

On February 5, a coalition of about 40 civil society organisations also issued a statement questioning the logic of the Ministries of Foreign Affairs and Health to export medics to a country whose health indicators and patient-to-health worker ratios are way higher than Uganda’s.

“The government should be ashamed,” said Sam Senfuka of White Ribbons Alliance Uganda. “They are supporting the export of our most prized resource — our health workers, who are in scarce supply in the health system.

“Export should only be considered if a country has a surplus; this is basic economics. We have thoroughly analysed this plan; it is wrong-headed and must be stopped.” 

SOURCE: The East African- http://www.theeastafrican.co.ke/news/Graft-claims-hit-Uganda-medic-export-scheme/-/2558/2615980/-/x8utqbz/-/index.html

Civil society opposes health workers’ export

WRA Uganda's Robina Biteyi News Interview with Amuka na BBC. Full Swahili bulletin here http://www.bbc.co.uk/swahili/medianuai/2013/11/000010_amka_na_bbc


By Alfred Wandera & Esther Bulyaba

A coalition of civil society organisations has added its voice to the criticism against Government’s move to export about 300 health workers to Trinidad and Tobago.
Addressing a joint press conference Thursday in Ntinda at Action Group for Health Human Rights and HIV/AIDS (AGHA) offices, the health activists demanded that Government stops defying its own evidence and substantially increases investment in the health sector.

The activists’ protestation comes barely a week after the Institute of Public Policy and Research (IPPR), a local think-tank, sued Government in what it says is one of the first ever public interest litigation cases concerning a medical "brain drain".

“Government should be ashamed. They are supporting the export of our most prized resource – our health workers – who are in scarce supply in the health system and are a national treasure,” said Sam Senfuka of White Ribbon Alliance Uganda in a joint press statement.

“Export should only be considered if a country has surplus; that is basic economics. We have thoroughly analyzed this plan and it is wrong headed and must be stopped,” added Senfuka.

Joshua Wamboga, the Executive Director of Uganda Alliance of Patients Organization (UAPO), said the implementation of the plan would increase suffering and preventable death in Uganda especially among pregnant women, newborns, HIV victims, tuberculosis and malaria victims and other leading causes of preventable death. 

“Government should be increasing health workers’ remuneration, improving working conditions and increasing the wage bill so that our clinics are finally saturated with motivated health workers. Instead, our duty bearers are defying their own evidence and want to actively support health workers to leave. We will not allow this to happen,”     said Wamboga.

Wamboga explained that their preliminary analysis of the Government plan indicates that any remittance generated by health workers exported overseas would fail to compensate for the economic costs associated with catastrophic illness and increased rates of death.

Uganda Nurses and Midwives Union (UNMU) president, Janet Obuni, said Uganda has failed to live upto the Abuja Declaration’s call for African states to allocate 15% of their national budgets to the health sector, leaving the sector in a sorry state.

“Uganda’s health budget is between 8 and 9% of the total national budget, which is way below the Abuja Declaration standard. We have a heavy disease burden but government is not investing in the health sector. Uganda’s current doctor to patient ratio is 1:15, 000; nurses to patient is 1:7, 000 and midwive to patient ratio is 1:9,000. This is against the World Health Organisation’s (WHO) required ratio of one doctor to 1500 patients, one nurse to 700 patients and one midwife to 1000 patients,” said Obuni.

Claire Mugisha, AGHA Advocacy Programme Officer, said the current national estimate of the quantity of health workers stands at 40,67 nurses and midwives and 4, 449 doctors, serving a total population of 35 million Ugandans.

Joyce Lucy Atim, UNMU national treasurer, claimed that some of the people listed on the Ministry of Foreign Affairs website are not qualified health workers, arguing that they were recruited following influence from their relatives and friends in the Ministries of Health and Foreign Affairs.

Ministry of Health Permanent Secretary, Dr. Asuman Lukwago, said the reason why Government decided to use the Ministry of Foreign Affairs to recruit health workers for export to Trinidad and Tobago is because it is foreign relations 
affair.

However, Lukwago said the Ministry of Health was involved in the selection process through the Health Service Commission.

“Those questioning the credibility of the shortlisted health workers have no competence and authority to do so. They can only come out to speak about it after consulting us,” said Lukwago.

He added that the decision to export health workers is aimed at arresting the scenario where most of them have drowned in the Mediterranean while trying to cross to overseas in search for green pastures.

“We don’t know how many health workers have died in the sea trying to cross to Europe and other developed countries. What government did was a formalization to make sure that things work out for them legally instead of them risking their lives,” said Lukwago. 

Source, New Vision: http://www.newvision.co.ug/article/fullstory.aspx?story_id=664520&catid=1&mid=53&utm_source=twitterfeed&utm_medium=twitter

Civil Society Demands Government of Uganda Halt Plan to Export Life Saving Health Workers

Walking for the Mother: Support for Maternal and Child Health Care

WRA members with their banner joined other citizens to walk for the mothers through the streets of Kanungu District Town. Photo by Cyprian Ntale

Report by Cyprian Ntale

WRA-Ug member

Kanungu District

Members of White Ribbon Alliance (WRA) for Safe Motherhood Uganda in Kanungu District participated in a charity walk dubbed "Walk for the Mother," to raise funds to support Rugyeyo Community Health Center in Kanungu District. The walk, which is part of the annual International Community of Banyakigezi meeting slated on 27th-28th December 2014, began in Kampala on December 6th (1st walk) and later went to Kanungu District on December 13th 2014. 

Kanungu District in south west Uganda will host this year's meeting with participants coming from all the four districts which make up Kigezi region i.e. Kanungu, Rukungiri, Kabale and Kisoro.

WRA members participated in both walks aimed at raising Shs 50 million. Professor Mondo Kagonyera and Rt Hon Prime Minister Dr Ruhakana Rugunda who was represented by Hon. Chris Baryomunsi were the chief walkers in Kanungu and Kampala respectively. Among other guests were; Bank of Uganda Governor Tumusiime Mutebile, Hon. Jack Sabiiti, Hon. Roland Mugume Kaginda and Mr Garuga Musinguzi. About Shs 25 million was raised at both walks.

Participants in the Walk for the Mother march in Kanungu to raise funds for a community health centre ahead of International Community of Banyakigezi Uganda chapter convention due on 27th December 2014 in Kanungu. Photo by Cyprian Ntale

Under the Saving Lives at Birth Project, WRA-Ug works together with AMREF Health Africa in Uganda and We Care Solar to light up health facilities with solar power, raise awareness and create demand for maternal and newborn health services and strengthening the health system in Kanungu, Kisoro, Rukungiri and Kabale districts.

Public health facilities lack resuscitation devices, newborn deaths high- study

Publish Date: Nov 15, 2014  

The commissioner clinical services at the ministry of health, Dr Jacinto Amandua addressing participants during the meeting. PHOTO/Agnes Kyotalengerire

By Agnes Kyotalengerire                     

Majority of public health facilities are lacking basic equipment to resuscitate newly born babies leading to a high number of newborn deaths, a study has revealed.The report also indicates that in the few health centers where there is equipment, medical workers do not know how to use them.

 “We lose babies who are born tired and cannot breathe because the health facility lacks equipment to resuscitate them,” said Barbara Zalwango a midwife working at Bulera health center III in Mityana district.

Resuscitation devices help to revive babies who fail to breath at birth a condition referred to as asphyxia.

The devices include: an ambu bag (neonatal bag) and mask, suction bulb and a training mannequin.

The study follows a survey that was conducted by White Ribbon Alliance Uganda in three pilot districts of Lira, Mityana and Kabale on the availability of newborn resuscitation devices has shown that most of public health center III and health center IVs lack equipment for resuscitating newborn babies.

Even where the equipment is available, health workers lack the skills to use it.

The national coordinator White Ribbon Alliance for Safe Motherhood Uganda, Robina Biteyi said none of the three districts met the minimum requirements for resuscitation of the newborns which leads to high number of newborn babies dying.

The study findings were revealed  during a stakeholders meeting organized by White Ribbon Alliance for Safe Motherhood Uganda on creating an enabling policy and  implementation framework for procurement , distribution  and availability of newborn resuscitation devices at Golf Course Hotel in Kampala  on Tuesday (yesterday).

 The district health officer Mityana, Dr. Fred Lwasampijja said the cases of newborn death in the district are alarming.

Dr Lwasampijja estimated that in a month about ten newborn babies die due to failure of midwives to resuscitate them when they are born distressed; tired and cannot breathe.

“These are few facility deaths but the number could slightly go up because some babies die at home and the cases are never reported to the health facility,” he said.

Dr. Victaria  Masembe working with WHO (left), the district health officer Mityana, Dr. Fred Lwasampijja(center) and the commissioner clinical services at the ministry of health, Dr Jacinto Amandua during the meeting at Golf Course hotel. PHOTO/ Agnes Kyotalengerire.

Bateyi said procurement of newborn resuscitation devices by ministry of health has been largely dependent on project by donors.

"Health centers cannot order for devices when they need them and mainly have to rely on the ministry of health to buy the devices when there is a funded project," she said 

 What the ministry of health says

The commissioner clinical services at the ministry of health, Dr Jacinto Amandua said with improvement in maternal and newborn health, focus is going to be put on acquisition of maternal and newborn equipment especially for resuscitation and also for helping mothers who have problems during delivery.

“The ministry is going to work with national medical stores to procure equipment for the public health units in addition to supplying medicines,” Amandua said.

He said procuring of resuscitation devices is only one aspect but it is important that every health facility has a skilled midwife to ensure the lives of mothers and newborns are safe.

Newborn mortality in health units is unacceptably high contributing to about 50% of deaths in children under the age of five years.

 According to the study, out of the nine health centers in Lira, only three had newborn resuscitation requirements.

In Mityana, out of 12 health facilities assessed, only 7 had the devices and in Kabale district 19 out of the 22 health centers had the devices.

This situation puts the lives of newborns at risk of death.

According to the Uganda Demographic health survey 2011, a total of 106 newborn babies die every day due to preventable causes.

Of these, 26% die on the first day of life due to failure to breathe and maintain breathing a condition referred to as asphyxia.

President of Uganda private midwives association, Mary Gorret Musoke said the ministry of health should plan with various stake holders to know how much is needed for each health facility, create a budget line for procurement of these devices and train the human resource to use the devices.

 Basic requirements for a labor suit

The president elect, association of gynecologists of Uganda, Dr Jolly Beyeza said a mother in labor should be attended to by two midwives; one extra to give a helping hand in case the baby comes out distressed.

Secondly, there should be a labor bed where a mother labors from, a delivery bed, a delivery kit with all the instruments required for conducting a delivery,  a resuscitation table with all the devices with a light up on the table to keep the baby  warm.

A partograph is also required to monitor the progress of labor, fetal heart.

Source: http://www.newvision.co.ug/news/661863-public-health-facilities-lack-resuscitation-devices-newborn-deaths-high-study.html

Citizen Participation in Budget Monitoring and Expenditure Tracking Requires Access To Information

Senfuka Samuel 
info@wrauganda.org/ bsenfuka@gmail.com

Mr Keith Meeting WRA team in his office. Photo by Faridah Luyiga

Faridah Mwanje after handling over WRA materials to Mr. Keith

Budget Transparency and Accountability: WRA-Ug meeting with Mr. Keith Muhakanizi Permanent Secretary/Secretary to the Treasury-Ministry of Finance, Planning & Economic Development. The aim of the meeting was to discuss a collaboration for making budget information available and accessible to citizens especially at district level. This is in line with WRA's citizen empowerment approach to monitor and track budget expenditures for Emergency  Obstetric and Newborn Care services at      their health centres.

"Ministry of Finance is happy and ready to partner and work with WRA and CSOs and provide all the necessary budget information. Our goal is to ensure that citizens are aware about their budget so that they are able to hold us accountable on fund releases and expenditures by ministries and districts," Muhakanizi pledges.

Ministry of Finance in the FY 2014/15 identified Budget transparency and accountability as one of the key interventions to strengthen institutional governance, accountability and transparency in public service delivery. Other interventions being undertaken to improve service delivery include:

• Publication of quarterly fund releases to ministries and Local Governments (both online and print media)
• Decentralization of the pay roll for civil servants
• Creation of a Uganda Budget Information Website, meant to enable citizens to access budget information of  resources allocated and utilized up to the local level 
• The ministry plans to establish an SMS platform and a phone Hotline for public feedback on budget utilization
• The ministry also conducts quarterly and annual budget monitoring and accountability through its Budget Monitoring and Accountability Unit and at effective implementation of Government programmes and projects.  

All the above are well-intentioned interventions to improve budget accountability and transparency but the question we should all ask ourselves is-how many people (citizens) are aware of these opportunities so that they can effectively participate in their budgets monitoring and expenditure tracking? It is often challenging to the community members to access budget information especially at district and sub-county level under the guise of confidentiality! Citizens need to be empowered to know their rights to access such information but also to use it in executing their obligation of monitoring and tracking utilization of the funds.

Ministry of Finance, Planning and Economic Development should strengthen the budget accountability and transparency by investing in grass-root budget information dissemination and empowerment of citizens with skills to monitor the budgets and tracking expenditures.

#ActNowToSaveMothers #Accountability#Transparency #CitizenParticipation#MaternalHealth #Commit2deliver

URGENT NEED TO REVIEW THE PROCUREMENT AND SUPPLY OF NEWBORN RESUSCITATION DEVICES

Dr Jacinto Amandua Commissioner Clinical Services-Ministry of Health speaking during a stakeholders'
breakfast meeting on newborn resuscitation devices convened by WRA-Ug at Golf Course Hotel, Kampala

MEDIA RELEASE

November 12^th 2014

For Immediate Release

(Kampala) In Uganda, 106 newborns die every day due to preventable causes. Of these, 26% die on their first day of life due to failure to breathe and maintain breathing, a condition referred to as birth asphyxia. These deaths can be prevented if resuscitation devices to manage birth asphyxia are available at the health facilities and health workers know how to use them. Basic newborn resuscitation devices include an ambu bag, mask, suction bulb and training mannequin.

The White Ribbon Alliance for Safe Motherhood Uganda conducted health facility  of government-owned heath centers III and IV on the availability of newborn resuscitation devices in three pilot districts; Mityana, Kabale and Lira. WRA Uganda found out that none of the three districts met the minimum requirements for the resuscitation of newborns. Out of 9 health centers assessed in Lira, only 3 had the newborn resuscitation requirements. In Mityana, out of 12 health facilities assessed, only 7 had the devices and in Kabale District, 19 out of 22 health centers had the devices. This puts the lives of newborns at risk of death.

The procurement of newborn resuscitation devices by the Ministry of Health has been largely dependent on projects by donors. Health centers cannot order the devices when they need them and mainly rely on the Ministry of Health to procure the devices when there is a funded project. Without adequate newborn resuscitation services in all districts across the country, newborn survival will continue to be a nightmare.

  

To reduce newborn deaths, the White Ribbon Alliance for Safe Motherhood Uganda recommends the following;

1. The mandate for procurement of newborn resuscitation devices should be given to National Medical Stores.
2. Resuscitation devices should be made vital commodities on NMS procurement list so that health centers can order them.
3.  Ministry of health should create a budget line for procurement of these devices.
4. Government should allocate more funds for procurement and repair of the equipment.
5. At least 5% of Primary Health Care funds should be allocated to maintenance of equipment.
6. There should be regular training for health workers so that they have the necessary skills to use and maintain the resuscitation equipment.

 Notes to editors

Within a minute of birth, a baby who is not breathing should be ventilated with a bag and mask. Although most babies breathe spontaneously at birth, up to 10 percent of newborns require some assistance to begin breathing. Only 3-6% require basic resuscitation, but the correct technique will save 4 out of 5 babies who need it. Every skilled birth attendant should be able to resuscitate a baby who is not breathing.[i]

The White Ribbon Alliance for Safe Motherhood Uganda is advocating for policy change for procurement of newborn resuscitation devices. The advocacy goal is; Ministry of Health (MOH) transfers the procurement of newborn resuscitation devices from its headquarters to National Medical Stores (NMS) in the FY 2015/2016.

# # #

For further information and to arrange interviews, please contact: Faridah Luyiga Mwanje on Tel; 0706835826/0772968685 Email: fluyiga@gmail.com or Elman Nsinda on Tel: 0704182962 Email: nsindae@gmail.com

Email: info@wrauganda.org, Web: www.whiteribbonalliance.org, Blog: http://wrauganda.blogspot.com Facebook: www.facebook.com/wrauganda, Twitter: @WRAUganda

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[i] Save the Children. Surviving the first day: State of the World’s Mothers 2013

A RAY OF HOPE AS KABALE RECRUITS SIX MEDICAL DOCTORS AT HC IVs

Settlements on the hills in Butanda, Rubaya Sub-county, Kabale District

By Senfuka Samuel
bsenfuka@gmail.com

“Dear Dr Patrick, we appreciate your effort and all those involved in this process to have the people of Kabale served better. I am okay with the proposed site and I will assume duty early next week. I request if possible help me inform the team in Rubaya Health Centre IV.” Dr Fortunate Asiimwe one of the interviewed medical doctors responded to a job offer by Kabale District Local Government.

“Dr Patrick am ready to serve,” Dr Davis Ahabwe posted to MPARO Health Centre IV committed

The enthusiasm of the newly recruited young doctors brings a ray of hope and smiles to many faces of the people of Kabale especially the women who have been traveling long distances to access comprehensive emergency obstetric care services such as cesarean sections from Kabale Regional Referral Hospital due to lack of doctors at health centre IVs. By all standards Kabale District is a hard-to-reach and hard-to-serve area. It’s over 400 KM away from the capital Kampala and has a rough hilly terrain with relatively poor access roads into the hills where majority of people live. This and other factors make it a big challenge to attract medical doctors and other health worker cadres to work in this part of the country.

Collaborative Efforts and Successes 
In 2013 a citizen led campaign code named Act Now To Save Mothers coordinated by White Ribbon Alliance for Safe Motherhood Uganda (WRA Uganda) was flagged off in Kabale, Lira and Mityana districts. The goal of the campaign is that the Government of Uganda upholds its commitment to ensure that comprehensive emergency obstetric and newborn care increases in health centre IVs from 17% to 50% and that basic emergency obstetric and newborn care services are available in all health centres. The campaign kicked off with a ground breaking participatory health facility assessment in all the three districts to establish the status of Emergency Obstetric and Newborn Care at all Government owned health centre (HC) IIIs and IVs. Twenty two (22) were assessed in Kabale District. The assessment findings showed that Kabale had NO medical doctor in any of its 7 health centre IVs hence none of the health centres could save a pregnant woman with emergency surgery.

Since then Kabale residents have used the findings in engagements with their district and national leaders through dialogue meetings, petitioning District, Petitioning Parliament, citizens’ voice, Videos, budget analysis and advocacy, marches, media among other campaign tactics to change this unacceptable state of health affairs.

The district political and health sector leaders are part of the campaign and they showed a strong level of willingness to do business unusual. They actively participated in health facility assessments and other campaign activities. The District Health Officer (DHO) led efforts to spot and request medical doctors to work in the district. “Despite the many challenges there is a ray of hope, our efforts have indeed started to pay off. I thank our partners for complementing the work of the district under the health sector. In a special way I thank WRA Uganda for dedicating time, resources, advocating and convening stakeholders around maternal and newborn health in the district and at national level. You have helped to refocus our health department priorities and generating ideas for improving maternal and newborn health service delivery,” a visibly happy DHO Dr Patrick Tusiime expressed.

Looking Forward

During a district leaders meeting convened by White Ribbon Alliance for Safe Motherhood Uganda on 17^th October 2014 at White Horse Inn, Kabale Dr Patrick Tusiime confirmed that three medical officers had  reported to their stations at Rubaya, Hamurwa and Mparo HC IV respectively. Others will go to Kamwezi, Maziba and Muko HC IVs. “These medical officers are all young people and there is need to be mindful of their personal ambitions and career growth. We have to explore all possible ways to motivate and retain them,” Tusiime cautioned leaders.

Dr Patrick Tusiime-Kabale District Health Officer addressing members 

during a meeting at White Horse Inn, Kabale. PHOTO BY SENFUKA SAMUEL

In a room filled with majority of District Councilors including the District Speaker, Secretary for Health and Secretary for Finance, the District Health Officer called on them to support and prioritize renovation and construction of staff houses in the planning and budgeting process for FY 2015/2016 which is underway. He added that there is need to continue advocating to central Government to increase financing of district lower health facilities, strengthening community participation and public private partnerships.

“We are currently facing a short supply of anaesthetic personnel on the market but the district has a three prolonged approach to address this gap. A plan is underway with the District Service Commission Chairperson to advertise the vacant posts. We are also discussing with the management of Kabale referral hospital to support the health centre IVs in case we fail to get the staff. The medium term solution will be to identify qualified persons among existing staff and recommend them for training in anaesthesia at Mbarara University and bond them for a specific period of time before they think of working somewhere else,” Dr Tusiime disclosed.

The District Councilors who sit on the district top policy making body (District Council) unanimously agreed to push for a recommendation of top-up allowance for the doctors in the next council meeting slated for November 2014. “Hon colleagues we need to act on this urgently. Llet us take this issue to the council through our Health Committee and District Executive Committee. We shall table a motion for a council resolution to provide a specified amount of top-up allowance for the medical officers and we have all agreed to support it,” District Speaker Hon Twinomuhangi suggested.

The district councilors concurred that motivation is not all about monetary benefits, they agreed to plan with the DHO to visit and meet with the new doctors and old staff at the health centres as a sign of care but also to talk to them about what the district plans to do to improve their working conditions.

A section of District Councilors during the meeting moderated by Mr. Julius Barusya at White Horse Inn-Kabale. PHOTO BY SENFUKA SAMUEL

A journey of a 1000 miles starts with the first step (Chinese Proverb) and Kabale District has made this step. As a minimum, the Government of Uganda must increase funding to fulfill its commitment to fully equip Health Centres III and IV with trained, motivated health workers and the tools they need to provide effective emergency care. And as citizens and other stakeholders we have to keep the momentum as watch dogs to ensure that this commitment is fulfilled.

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