Five Ugandan youth to attend Women Deliver 2013

By Vision Reporter
Publish Date: May 22, 2013

Five Ugandan youth are among 100 youth leaders from all over the world selected to attend Women Deliver 2013, a global conference that will bring together over 5,000 leaders, experts and advocated from 160 countries in Kuala Lumpur, Malaysia next week.

Women Deliver is the decade’s largest global conference focusing on girls’ and women’s health and empowerment.

The conference aims at keeping on the global agenda the issue of investments in girls and women.

Uganda has the largest number of youth leaders from one country. The youths will have the opportunity to learn more about women and girl issues and connect with experts from around the world.

Elman Nsinda, a journalist volunteers at the White Ribbon Alliance to advocate for maternal and newborn health issues. He is one of the delegates.

Nsinda believes that to improve women and children’s health, men need to be tasked to explain when their wives deliver at home and get complications.

“In our community boys don’t understand women issues. I have just started appreciating that what I need, a woman also needs,” he says.

He argues that men in our society are the ones with the economic muscle. “It is their role to save money, to make decisions,” he says.

Orphaned in Primary One, Nsinda was raised by a grandmother. At 17, she too passed away and he was taken on by a paternal aunt.

“I was raised by women and I have seen and understand their challenges,” he explains and this inspires him to work for their cause.

Martin Wanzala, another of the young delegated to Women Deliver believes culture is the biggest impediment to progress in achieving reproductive health.

The team leader at Allied Youth Initiative–Uganda, a youth organization in Mbale has observed that culture envelopes the discussion around sexual and reproductive health issues.

He says young people cannot freely discuss reproductive health issues because of cultural taboos.

“We use drama, music and dance to deliver the message in a gentle way,” he says.

Humphrey Nabimanya, another young leader and founder of Reach A Hand Uganda testifies to the power of the arts in engaging young people for health.

Source:  http://www.newvision.co.ug/news/643037-five-ugandan-youth-to-attend-women-deliver-2013.html

Doctors have decried the poor health-seeking behavior common among Ugandans, saying the practice is not only costing patients a lot of money but is also costing the country lots of lives.

By John Agaba
Publish Date: Feb 27, 2013

Dr. Simon Peter Eyoku, a senior nephrologist [kidney expert] at Mulago Hospital says most Ugandans wait until they are critically ill until they can go to hospital.

“They come when it is already late and they want to be saved. How? But most of these diseases can be prevented or stopped when diagnosis is done early.”

Citing kidney disease, Eyoku says the loss of function usually takes months or years to occur. “So when urine samples tell someone is developing the disease, they can be given medication to support the organ and prevent it from shutting down.”

The kidneys are responsible for cleansing the blood stream.

The medic says people have to learn to test for kidney disease, diabetes, hypertension, cancer, and any other ailments every after five months even if they feel fine, no matter their age.

He explains that patients with mature disease (end-stage renal disease) usually are put on dialysis, “but do you know how expensive the treatment is?”

“At Mulago Hospital, for a week, patients pay sh1m; two weeks it is sh2m. And that is at Mulago, other hospitals charge more than sh2m per week.’’

“Now if you are to spend a year on the machine, how much money is that? And can you afford it?”

He admits that much as medicine has evolved and doctors can carry out transplants, kidney transplants are still not possible in Uganda. The patient has to be flown to India.

“The patient has to first get a kidney donor and then be flown to India. And not everyone is transplantable. At times the body can refuse the other kidney despite the drugs and the patient has to be put back on dialysis.’’

Diabetes and high blood pressure are the commonest causes of kidney disease.

‘Healthy lifestyle’

Earlier, last week, during the health journalists conference at the Kampala Imperial Royale Hotel, medical experts stressed the need for emphasis on preventive health than curative health.

Dr. Fred Okuku, an oncologist and head of the cancer institute at Mulago Hospital urged people to start practicing healthy lifestyles.

He underscored the need for people to involve themselves in physical exercises, to avoid eating fatty and sugary foodstuffs ‘to minimize on some of these non-communicable diseases’.

The doctor said there was lots of illiteracy surrounding the cancer disease yet the disease is growing by the day. And that the numbers of cancer patients at the institute are ever going up and most of them are presented with advanced disease.

“Right now if a patient comes to the institute and his prostate has to be taken out, he is booked for 2014,’’ said Okuku.

He said cancer of the cervix which is caused by the HPV virus was the commonest, closely followed by breast cancer.

Elsewhere, Dr. Olive Ssentumbwe Mugisa, the chairperson of the White Ribbon Alliance Uganda Chapter called on women to try and have pregnancies at the right age – between 20 years and 34 years – to avoid child-birth related complications.

“And don’t get pregnant too frequently,” was her crisp reminder.

“Space and use family planning. Someone has a baby today. But before the baby is off the breast she is already pregnant. This wears the body.”

The maternal mortality ratio in Uganda has changed minimally over the last decade and about 16 women still lose their lives daily. This statistic is coupled with some 45,000 newborns dying every year as a result of pregnancy-related causes.

But about 88% of these maternal deaths can be prevented.

“For nine months someone is pregnant,’’ said Dr. Olive. “During this time they don’t attend antenatal classes and they think they will give birth at home, perhaps with the help of a traditional birth attendant.”

“What happens when they develop complications at the last hour? They don’t have money. The nearest health facility is about 10 kilometers away. They reach the hospital when the baby is already dead. Now what do you want the midwife to do?”

“Both you and me – men and women – have a duty to see that we reduce the numbers of women and children who die because of pregnancy-related complications. (And for) the man, you need to start setting aside some money the moment your wife gets pregnant, and accompany her for antenatal classes.”

Source: http://www.newvision.co.ug/article/fullstory.aspx?story_id=640188&catid=10&mid=53

CSOs Reaction to the FY 2013/14 Budget Speech

Civil Society Coalition to Stop Maternal Mortality in Uganda

Reaction to the Financial Year 2013/14 Budget Speech

For more information contact: Samuel Senfuka, White Ribbon Alliance Uganda: 0704920043

Dennis Odwe, AGHA Uganda: odwedennis@yahoo.com, 0772637740

Nakibuuka Musisi, CEHURD: nakibuukamusisi@gmail.com 0782496681

Asia Russell, Health GAP: asia@healthgap.org, 0776574729

(Kampala) In reaction to the release of the Budget Speech 2013/14 today 13 June, 2013, a coalition of health advocacy organizations released the following statement: “The 2013/14 Budget does not prioritize the most important issues facing Ugandans—it contains massive budget increases for State House and for Defense while health investments that literally mean the difference between life and death for millions of Ugandans have been starved for funding.

‘The economic growth described by President Museveni’s in his June 8 State of the Nation Address is virtually meaningless when communities cannot reliably obtain essential health care in facilities that have the staff, medicines, and equipment needed to save lives,’ said Nakibuuka Musisi of CEHURD.

Furthermore, Government is proposing new regressive taxes in a misguided attempt to fill a revenue gap triggered by aid suspension in the wake of massive theft of donor funding. This policy decision by government will further punish ordinary Ugandans—the victims of theft of public funds—while corrupt officials walk free. ‘Government’s proposed 18% VAT on water is actually a typhoid tax,’ continued Musisi. ‘Corruption already makes us sick—why does government want to punish us further?’

We call on Parliament to stand by their constituents and insist that this Budget is not passed unless and until the following changes are reflected in the 2013/14 Appropriations Bill:

1. Wages for priority health worker cadres must be increased across the health sector, in particular at HC IVs and HCIIIs, in particular midwives, anesthetists, and laboratory technicians. At minimum this will require an investment of Ushs 77.9 billion. Without this investment, the successful recruitment of thousands of new health workers will be in vain—they will be not be motivated to work and will move on to other jobs. Non-financial motivation (staff housing, etc.) for health workers must also be expanded.

2. Dramatically increase the investment in priority medicines, including ARVs and ACTs, recognizing the large unmet need for HIV treatment and anti malaria treatment (including in particular prevention during pregnancy, which will contribute to a reduction in maternal mortality). Government funding for HIV treatment must be scaled up, given the new HIV treatment coverage gap that will be created in 2013 as a result new WHO treatment guidelines, and in order to leverage the fact that Uganda can massively reduce HIV incidence through earlier access to HIV treatment—while saving lives: evidence shows that

Providing treatment for all in need in Uganda would help decrease new HIV infections by 60% and more than 100,000 deaths could be averted over just 4 years.

3. Absorb the costs of an expiring donor grant for paediatric HIV treatment and Early Infant Diagnosis. The total cost for paediatric ARVs and for diagnostics for this grant is Ushs 10.8 billion.

4. Absorb costs required to continue the donor funded, expiring program on Integrated Community Case

Management for malaria.

5. Ensure recruitment of sufficient numbers of staff at General Hospitals and Regional Referral Hospitals

(through second wave of recruitment in remainder of FY 2012-13 and/or through budget for FY 2013-14).

6. Reflect the President’s London Summit Family Planning commitment with increase in additional expenditure for reproductive health commodities by 5 billion shillings each year for 5 years.

‘Uganda lags behind the region and much of the continent in addressing crucial health priorities, from rising HIV incidence, to persistently high rates of maternal death, to preventable deaths from malaria and vaccine preventable illnesses. This is shameful and unacceptable,’ said Dennis Odwe of AGHA Uganda.

‘Uganda cannot be strong economically without tackling these preventable health crises,’ said Samuel Senfuka of White Ribbon Alliance Uganda. ‘Our development suffers when Ugandans cannot gain access to essential health services.’

‘We are well aware that diarrhea diseases are the second leading cause of under five mortality, and an 18% VAT on water is self defeating in achievement of our health goals. Moreover we know that access to safe water is key in the fight against HIV and retention of children in schools,’ said Hellen Kasujja of CIDI. ‘Such a regressive tax will have grave implications, especially on women who are at the epicenter of our economy.’

Civil Society Reaction to State of the Nation Address 2013

Civil Society Reaction to State of the Nation Address

A Coalition of Civil Society Health Experts Respond to President Museveni's State of the Nation Address 2013. 

(Kampala) Today June 6, 2013 a coalition of civil society organizations fighting for realization of the right to health in Uganda issued the following statement in reaction to President Museveni's State of the Nation Address:

"Uganda today is lagging behind the region and much of the continent in addressing crucial health priorities, from rising HIV incidence, to persistently high rates of maternal death, to preventable deaths from malaria and vaccine preventable illnesses. This is unacceptable.
Uganda cannot develop economically as a country without tackling those crises. Our development suffers when Ugandans cannot gain access to essential health services.

Ironically, scientific advances show that right now Uganda could benefit enormously from accelerated investments in the fight against these preventable killers--for example, by aggressively scaling up access to HIV treatment along with other high impact interventions, Uganda could prevent more than 100,000 deaths and slash HIV incidence by up to 60%. By equipping Health Centre IVs and IIIs with the equipment and personnel needed to provide emergency obstetric care, thousands of mothers' and babies lives could be saved.

But today the President gave only superficial mention to these issues in a State of the Nation Address that should have prioritized the fundamental issue of lack of access to quality essential health
services.

For example: today staff in Fort Portal are striking over lack of pay; pregnant mothers are dying without access to safe blood due to lack of supply of testing reagents; nationally, rapid test kits for HIV
detection are almost out of stock; midwives are paid almost nothing working at the frontline to deliver babies--this is disgraceful, and the Financial Year 2013/14 Budget must address fix these problems, or Parliament should not pass it. Furthermore, right now the President is not taking action in response to massive pressure from the EU and US to force Uganda and other least developed countries to accept a deal on generic medicines that would cripple our ability to access affordable treatment.

Unfortunately, we heard nothing in the speech today that indicates the fundamental change needed--genuine prioritization of the health sector through sufficient funding and the political will needed to ensure the sector functions well--bringing essential services to communities most in need, in order to save lives."

State of the Nation Address 2013- http://www.youtube.com/watch?v=Jrti7RTYIss

For more information, contact:

1.    Samuel Senfuka, White Ribbon Alliance Uganda: 0704920043, bsenfuka@gmail.com

2.    Dennis Odwe, AGHA Uganda: 0772637740, odwedennis@gmail.com

3.    Moses Mulumba, CEHURD (Centre for Health, Human Rights and Development) :  0772657974, mulumbam@gmail.com

What 8 Women Wish they Knew Before Giving Birth

Posted by WRA Uganda

Ingrid Turinawe, FDC Women League leader, and mother of five children aged between 10 and 19
“No one had ever told me that immediately after birth and the baby cries, the mother becomes so overjoyed and excited. It is something that I got to discover on my own after giving birth to my first born child. In my mind, I was like why didn’t anyone tell me about this awesome feeling. I remember just weeks before going into labour, the mothers that I would chat with would narrate only scary tales about the child birth process. None of them ever told me that soon after birth, a certain overwhelming feeling takes charge of the mother’s body. .”

Harriet Anyango, 38, farmer and mother of two children
“I would be having three children but the second born died just days after delivery. My baby boy was just a few weeks old when he got malaria that claimed his little life. I gave birth to my 15 year old as well as my two year old son naturally but for this second child, it was through caesarean. The pain I felt immediately after the surgery was very agonising. It was even more than the labour pains I had encountered before. I could not sit or stretch any part of my body. In fact I was crying all the time. The pain subsided after about three days. Can you imagine even before going into surgery, no nurse or doctor bothered to tell me what pain to expect immediately after the C-section was done? It was such a traumatising experience for me.”

Betty Nambooze, MP, with 26 adopted children
“I have two children whom I have given birth to naturally. The whole process of giving birth to these two children seemed as if I was battling hard for my life. In other words, it was as if someone was trying to kill me. Can you imagine such a thought! I used to think that it was a matter of going to the labour ward, push the baby and immediately go back home. Honestly, no woman had ever told me about this battle that every expectant mother had to fight as well as win while inside the labour ward.”

Florence Mulindwa, 20, mother of a three month old baby
“I felt the urge of breastfeeding my baby immediately after it was born. However, there was one problem. I had no milk. When I asked the midwife why the milk was not coming from the breasts, she told me that I had not been cleaning my breasts with warm water. This water was meant to remove the so-called “sticks” from the nipples. Once the sticks were off, the milk would flow freely. The midwife told me that it was something I was expected to do right from the early stages of my pregnancy. But since I had not done that before, she told me to wait for a few more days. As I waited anxiously, my breasts were becoming painful. Her advice was very good though I wished someone had told me about it during my early stages of pregnancy.”

Lillian Ajio, 18, mother to a 6 months baby boy 
“I became pregnant while in my Senior Three. I was very young and did not know anything regarding child birth. When the time came for me to deliver, I went to the labour ward totally blank. The midwives were the ones guiding me on what to do most of the time. For instance, they gave me instructions on how to push the baby and how to hold it since it was very tiny. Different mothers had told me before that the midwives would take advantage of my tender age to mistreat me in the labour ward. But they did not do any of that. Those women were very helpful and encouraging. That was something I least expected from them.”

Judith Babirye, Gospel musician and mother of one daughter
“A few years back when I gave birth and immediately started breastfeeding my baby, the experience was quite tormenting. My breasts would pain a lot each time the baby was suckling. Whenever I shared this experience with other women, they would say, I was pretending and yet I was not. But I later got to learn of some other mothers who had gone through the same experience as mine. I just wish someone had at least warned me about such pain once breastfeeding started.”

Pauline Nalubega, 50, mother to a year-old daughter
“When I was going to give birth, the majority of my female friends who had children told me that the pain would only come from the lower part of my body. Little did I know that they were deceiving me? I got the worst headache a human being can ever get when I was pushing my child. At one point, I thought that I was going to die. That headache was just too much. Also, there was a bit of back pain as well, though it was not that bad. If someone had told me earlier that the deadly headaches were part of the deal, I would have been prepared for them.

Suzan Muwonge, rally driver and mother of two
“I had heard of stories of how the whole process of child delivery was very excruciating, I thought that when my turn comes, everything would just be a walk over. But when my turn came, I screamed, shouted and said all sorts of things. I even swore never to get pregnant again. This was especially with my first pregnancy which I had kept a secret from most family members.”

Source: Daily Monitor-http://www.monitor.co.ug/Magazines/Health---Living/what-8-women-wish-they-knew-before-giving-birth/-/689846/1757158/-/y8npn3z/-/index.html

Health Centers in Kigezi Sub Region Get a Boost for Safe Motherhood

Installation is already underway

By Nsinda Elman

White Ribbon Alliance Uganda

On 6^th March of 2013 Kigezi region saw hope being restored for mothers when the regional populace witnessed the launch of a three year maternal health project code-named  “Saving Lives at Birth (SLAB)”, by three partners including The White Ribbon Alliance for Safe Motherhood- Uganda, African Medical and Research Foundation Uganda (AMREF) and We Care Solar.

Under the Saving Lives at Birth project, 200 health centres in Kabale, Kisoro, Kanungu and Rukungiri districts will be provided with solar power to ensure reliable lighting in maternity wards, delivery rooms and operating theaters.

Speaking during the official launch of the project at White Horse Inn, Kabale Town on Wednesday 6^th March 2013, The National Coordinator White Ribbon Alliance Uganda disclosed that the alliance would like to use such an innovation as a research case to find out how it can contribute to motivation of health workers and reduction of maternal and neonatal deaths. She also said that WRA Uganda will ensure that communities are empowered to hold their leaders and maternal health service providers in public facilities accountable and demand what they deserve such as more budget allocations to maternal health.

The AMREF Ag. Project Manager Morish Ojok said that: “the project is aimed at helping midwives who have been struggling with candle light to deliver pregnant mothers, with sufficient light so that they are able to save lives of mothers and their newborns.

 A kerosene lantern used at Bigunjiro Health Centre in Kabale district to provide lighting at the
    facility. It'is one of the facilities to benefit from the solar power installations through SLAB project

Kabale District Health Officer, Dr Patrick Tusiime, expressed optimism about the project and described it as a real victory for the region. He however showed concern about the absence of more other supplies and equipment which should be used such as delivery beds, delivery kits and sterilizing equipment.

Among other things to be provided to health centers are laptops to capture maternal and neonatal data as well as facilitating eLearning for midwives and nurses. The solar suit case also comes with an electronic Fetal Doppler for sensing the pulses of the pregnant woman and her feotus, rechargeable headlamps and a provision for charging mobile phones.

An estimated one million mothers living in Kigezi Sub-region are expected to benefit 

from the SLAB project.

Let us act collectively to save our dear women during pregnancy and childbirth.

Government of Uganda Recruits 5,707 Health Workers

On the left is the Ministry of Health team and on the right a section of MPs listening to a presentation by CSOs during a Health Committee meeting at Parliament of Uganda

By Senfuka Samuel
WRA Uganda

On Tuesday 19^th February 2013, the Ministry of Health team led by Minster of State for Health (General Duties) Hon. Kataike Sarah, Permanent Secretary Dr. Asuman Lukwago and Director General of Health Services Dr. Jane Aceng presented to the Health Committee of Parliament a progress report on recruitment of 10,231 health workers as committed by government in FY 2012/2013. The minster reported that 5,707 health workers had been offered jobs countrywide as of 15^th February 2013. In October 2012 during the national budget discussions, the Government of Uganda took a bold decision out of concerted advocacy efforts by Parliamentarians, Civil Society Organizations in health and other stakeholders to recruit 10,231 health workers for HC IVs and IIIs to avert a human resource for health crisis in the country.

According to the ministry report, 36,891 applications were received across the country, shortlisted, interviewed and 7,586 passed the interviews. As of 15^th February 2013, the districts had offered 5,707 jobs and 1,533 reported to their duty stations.

The Civil Society Coalition to Stop Maternal Mortality in Uganda and the Coalition for Maternal, Newborn and Child Health on the invitation of the Health Committee also presented their key observations and recommendations that were based on information collected from the District Health Officers and District Service Commissions.

“The Ministry has made some measurable achievements despite the logistic and technical challenges encountered in the recruitment process. This time round the ministry of health has been very committed to ensure at least minimum staffing levels at health centre IVs and IIIs which are nearer to the majority of the people. In the subsequent financial year 2013/14 we ask ministry of health to make it a priority to enhance the wages of lower cadres such as midwives along with further non-financial motivation for medical officers in HCIVs.” Said Senfuka Samuel of WRA Uganda during a presentation to the committee on behalf of CSOs.

According to CSOs information from districts, some districts have failed to attract certain cadres and the ministry agrees with this. For instance Kabale district advertised 12 posts for medical doctors to fill vacancies in their six health centre IVs but managed to recruit only two, Bugiri district advertised 2 posts and failed to attract any. These HC IVs have gone for years without doctors.

A visibly sad Senfuka Samuel add that: “Most HC IVs lack functional operating theatres and lack or have inadequately skilled medical officers, unable to perform Emergency Obstetric Care (EmOC) and newborn care tasks yet a primary objective of establishing HC IVs was to provide facilities for comprehensive EmOC services such as caesarean sections and any other emergency surgery, blood transfusion.”

Senfuka Samuel, WRA Uganda presenting on behalf of CSOs in health a report on health workers recruitment to the Health Committee of Parliament at Parliament as MPs listen.

Ministry of health further highlighted some challenges encountered during the recruitment process some of which will require short term while others long term remedial solutions. For instance failure to attract enough applicants for certain posts e.g. out of the advertised 371 medical officers only 165 were recruited, 1,095 advertised posts for Clinical Officers only 749 were recruited, 1,371 posts for Enrolled Midwives were advertised and 745 were recruited, 449 Anesthetists posts advertised only 51 recruited and 229 posts for Theater assistants but only 54 were recruited. According to MoH some cadres of professional health workers are insufficient in supply because of no more production of such cadres like Theater assistants, anesthetic assistants or few institutions are producing them where as others are due to policy gaps. For instance Uganda stopped producing midwives in 2006 on the premise that the comprehensive nurses could be trained in both nursing and midwifery skills and perform a dual function. However, this has raised continuous debate and resistance from the traditional mainstream midwifery professionals and associations that comprehensive nurses do not have adequate skills and competences to perform midwifery functions hence they were denied an opportunity to apply as midwives in the recruitment drive.

Some districts did not have District Service Commissions in place which delayed the exercise hence reliance on the neighboring District Service Commissions.

Recommendations and way forward 

• Ministry of Health immediately assesses the number and cause of gaps in the recruitment exercise, per District, and prepare in partnership with District officials remedial action to ensure all 10,231 qualified health workers are identified and deployed as quickly as possible. This should include immediate re-advertising of still-vacant positions and possibly those created as a result of promotions of health workers or crossovers to other districts
• Ministry of Health should make it a priority in FY 2013/14 to enhance wages of lower cadres of health workers along with further non-financial motivation for medical officers in HCIVs. 
• Ministry of Education and Sports should closely work with Ministry of Health and partners to draw a training strategy of cadres who are in short supply in addition to scaling up the six month midwifery course for comprehensive nurses in post as one of the remedies
• Ministry of Health should accelerate the consideration of a policy to recentralize recruitment and deployment of doctors
• Ministry of health should provide a budget to induct newly recruited health workers
• Ministry of Health, Parliament, CSOs, media and other stakeholders should ensure that the promise by the Executive/ Ministry of Finance to provide a supplementary budget of Ushs43 billion is not broken, despite financial problems triggered as a result of theft of public funds and subsequent suspension of funding by some development partners
• Ministry of Health in collaboration with Ministry of Public Service and Ministry of Finance should ensure that any arrears owed to Health Centre IV doctors who were in post by 1st October 2012 are posted on their accounts and all newly hired staff access on the payroll as soon as possible