National Medical Stores Bring Us Condoms Instead of Medicines!

Bill Oketch

An article written by Bill Oketch, a journalist with Arabkop-a Luo News Paper for Lango Sub-region. Bill also works as a regional correspondent for Daily Monitor  News Paper (national) in charge of Lango and Acholi sub-regions (Northern Uganda). He was part of the journalists who participated in a participatory health facility assessment of emergency obstetric and newborn care services in Lira district coordinated by The White Ribbon Alliance for Safe Motherhood Uganda under an accountability advocacy campaign "ACT NOW TO SAVE MOTHERS" in collaboration with the office of District Health Officer Lira. Bill was part of the team that visited Aromo HC III and Ogur HC IV in Lira district and writes from first hand information.
For our friends who understand Luo enjoy the article and the comments are very welcome!

A Host of Challenges Hinder Delivery of Life-Saving Services for Pregnant Women in Mityana

 By Senfuka Samuel

bsenfuka@gmail.com

Ruth showing a lamp she uses during delivery of mothers at
her health centre

Ruth is a #midwife at Bulera health centre III a rural health centre in Mityana district, central Uganda.

Despite the challenges she narrated to us during assessment of basic emergency obstetric and newborn care services at her facility Ruth still puts on a smile because she loves her profession as a #midwife. Many times she delivers mothers at night using the kerosene lamp or her mobile telephone torch. "My only delivery instrument set lacks key instruments like episiotomy scissor, cord scissor, forceps. I always improvise. We only have rain harvested water at the facility. During dry season we pay someone to fetch for us from the community well which is away from here. Attendants have to fetch their own water for the women in labor or pay the same person to fetch for them." Ruth added that: "Some mothers/women come without any attendant and a single coin but as a midwife you have to ensure that she has a safe delivery. If there is a complication we refer to Mityana hospital but transport is a big challenge.     

Non-functional Blood Pressure Machine at
Bulera HC III

Mothers have to look and pay for their transport but some of them do not come with money. I have paid transport for some of the mothers. If I were a president I would ensure that health centres are well equipped to save the mothers"

The blood pressure machine for maternity unit at Bulera HC III has been non-functional for over a year due to lack of batteries! This means with the focused antenatal care a midwife can not check the pressure of a pregnant woman or those in labor. They diagnose by symptoms and observation! Studies show that 8% of all maternal deaths in Uganda are caused by pre-eclampsia and eclampsia hence not checking                                                                                     the pressure of pregnant mothers can be disastrous.

The government should ensure that sufficient funds are allocated to meet such simple but high impact means of saving the lives of thousands of mothers in Uganda - #ActNowToSaveMothers

Pregnant Women Still Travel Long Distances to Access Life Saving Services

Dr. Richard Okello at a health facility
assessment meeting of EmONC at Ogur HC IV

By Senfuka Samuel

Despite recruitment of medical officers none of the only two health centre IVs in Lira district, northern Uganda conducts cesarean sections, uterine rupture repairs and blood transfusion services to save lives of women who face obstetric complications. "We feel demotivated because we are redundant. The theater is well equipped but we cannot do our work because it needs urgent renovations to avoid any infection contraction during operations. My colleague is contemplating of leaving" Dr. Richard Okello, Senior Medical Officer Ogur HC IV, Erute North.

In response to Dr. Richard's frustration, the Ogur Sub county Chief Ms Toli Eunice said that: "This health facility assessment of emergency obstetric and newborn care services by White Ribbon Alliance has been an eye opener to us because we have not been taking emergency care services as a key priority. When we got a doctor we only thought of renovating his house but now we are also going to prioritize the theater in 2014/15 financial year"

Community members, health-workers and leaders conducting a health facility assessment of the
facility at Aromo health centre

White Ribbon Alliance for Safe Motherhood Uganda is coordinating an accountability campaign code-named "Act Now To Save Mothers" aimed at advocating to the Government of Uganda to uphold its commitment to ensure that comprehensive emergency obstetric and newborn care increases in health centres IV from 17% to 50 % and the basic emergency obstetric and newborn care services are availalbe in all health centres by 2015. WRA Uganda is conducting a health facility assessment of EmONC together with community members and district health office and leaders in Kabale, Lira and Mityana to generate evidence for requesting sufficient funds in 2014/15 financial year so that local governments deliver these life saving services.

Surgical bed @Ogur HC IV

Theater building @Ogur HC IV which
requires urgent renovation

Inside the theater @Ogur HC IV

KEEP YOUR PROMISE TO THE MOTHERS AND CHILDREN OF UGANDA

A new mother with her newborn at Ogur HC IV, Lira district Northern Uganda

Robina Biteyi

National Coordinator, WRA Uganda

At the 68th UN General Assembly in New York the World Bank Group, UNICEF, the U.S. Agency for International Development and the Government of Norway committed $ 1.5 billion in financing over the three years to help achieve Millenniums Goals  (MDGs) 4 and 5, which focus on reducing child mortality and improving maternal health and reproductive health including access to contraception. Both MDG 4 and 5 are most off-track of all the development Goals.

This commitment and the renewed efforts to accelerate the achievement n of both MDGs 4 and 5 must be commended and applauded. However, this must be supported by an equally committed national local response.

Estimates show that ensuring all women who want to use contraception can access it the maternal mortality would be reduced by 30 percent globally. Uganda’s maternal mortality ratio stands at 438/100,000 live births (UDHS, 2011). Neonatal mortality is estimated at 21/1,000 live births. First day deaths are estimated at 15,100 in total the country looses 42,000 newborns annually; this contributes to 12% of the under-five mortality rate.

It is clear that family planning plays a big role in reducing maternal mortality. Every woman should be supported to choose if and when to become pregnant in the course of her life. This will keep more women and their children alive and productive members of their society.

However, let us not lose sight of the important life saving role of ensuring that every woman and her newborn have access to both basic and comprehensive emergency obstetric care. It is estimated that at least 15% of all pregnant mothers will need life saving emergency obstetric care. Uganda has committed to providing basic emergency obstetric and neonatal care (EmBONC) at health centers 111 and comprehensive emergency obstetric and neonatal care (EmCONC) at health centers 1V. This effort has been constrained by inadequate human resources with life saving skills (doctors, midwives and nurses with midwifery skills. This coupled with inadequate equipment and supplies have  put the lives of mothers and their newborns at risk and have contributed to the persistent high maternal and neonatal mortality in Uganda.

With only 829 days until the MDG deadline of December, 31, 2015. We would like to appeal to our Government to uphold its commitment to ensure that no woman dies during pregnancy and childbirth and every newborn is born alive and survives to be a healthy and productive member of his/her society.

See President Museveni's Statement at 68th UN General Assembly: http://www.newvision.co.ug/news/647622-president-museveni-s-address-to-un-general-assembly.html

We ask you to keep your Promise. Act Now To Save Mothers

Health sector suffers underfunding as maternal deaths rise

By FLAVIA LANYERO

Posted  Saturday, September 14   2013 at  01:00

IN SUMMARY

Crucial items needed by health workers such as antiseptics, surgical blades and gloves missing in government health centres leading to deaths in some instances.

KAMPALA

For Leah Nambirige, life as a midwife is no longer fun. For six months now, she says Mityana Hospital has not had antiseptics, surgical blades, and gloves.

These are crucial items needed by health workers without which child delivery cannot take place. As a result, Ms Nambirige says they have had to turn away several mothers who have not come with these items.

“Some mothers accept and buy these items but others refuse and decide to go to Mulago Hospital. We cannot always chip in and use our money to buy these items,” Ms Nambirige says adding: “Ultimately, this running back and forth of expectant mother to buy these commodities becomes a delay which contributes to a maternal death.”

Ms Sarah Nyombi, a board member of the National Medical Stores (NMS), however, says it is peculiar that the hospital has not had these commodities since NMS delivers only what is requisitioned by hospitals and said the issue would be probed.

But then, the nurses face another challenge. According to Ms Nambirige, nurses are overworked and intimidated by politicians who have come up with a new by-law to cause arrest and prosecution of medics in whose hands a maternal death occurs.

Ms Robina Biteyi, the National Coordinator White Ribbon Alliance for Safe Motherhood, says it is no longer women dying every day due to maternal complications but now 17 mothers and 106 newborns die every day in Uganda partly due to inadequate government investment in life-saving emergency obstetric and newborn care.

Dr Olive Sentumbwe, a family health advisor at the World Health Organisation, says that at the rate at which Uganda is moving, the MDG of 131 deaths per 100,000 live births by 2015 is still unattainable.

Although government’s contribution to the health sector has increased, it hardly matches the growing population needs. This financial year, government allocated only 8.7 percent of the budget to the health sector up from 7.8 percent the previous financial year but this is still below the 15 percent commitment in the 2001 Abuja declaration.

State Minister for Finance in-charge of planning Matia Kasaija, however, says that it is too late to add any money for the health sector this financial year. Mr Kasaija said that although it is possible to increase funds next financial year, governments priority remains infrastructure and electricity.

flanyero@ug.nationmedia.com

Source: http://www.monitor.co.ug/News/National/Health+sector+suffers+underfunding+as+maternal+deaths+rise/-/688334/1991380/-/2jfedp/-/index.html

Give our health sector attention

EDITORIALDaily Monitor Posted  Wednesday, August 14   2013 at  01:00

The unrelenting reports of human resource challenges within the country’s health sector should cause us to pause and consider the health sector situation in order to make practical and progressive steps.

Last week, figures from the Uganda Medical and Dental Practitioners Council showed that more than 2,000 (nearly 50 per cent of the registered number of medical practitioners) had left the country in the past 10 years.

Now the latest report on human resources for health shows that some 1,124 health workers had not reported for duty as of June this year yet they were expected to take over their new offices by the beginning of 2013.

There are clear indications of government’s willingness to deal with these problems and some commendable steps have been taken in that direction. The release of an additional Shs46 billion for recruitment of health workers last year is one of those commendable steps.

Unfortunately, according to the Human Resources for Health report in some districts, there was a notable failure to attract some workers, particularly anaesthetic assistants, ophthalmic clinical officers, public health nurses, dispensers, theatre assistants, cold chain assistants, midwives, and mostly senior medical officers.

Reports from some districts show that the rate of health workers reporting to work after appointment was greatly affected by lack of staff accommodation. Still, for the health workers who reported to work, their retention will be greatly determined by the availability and state of their accommodation, according to the report.

Despite assurances from Health minister Ruhakana Rugunda, that the recruitment exercise was continuous and that other health personnel continue to report for duty as their accommodation issues are being resolved, the government will have to do more in regard to improving the remuneration and working conditions of the health personnel.
Unsustainable stopgap measures will only work to aggravate the current health sector problems.

The government would indeed do well to heed the recommendations of the report, as it calls for partners and all stakeholders to prioritise staff accommodation as a strategy to address the issue of health worker attraction, retention and motivation.

Source: http://www.monitor.co.ug/OpEd/Editorial/Give-our-health-sector-attention/-/689360/1947080/-/3o8y6oz/-/index.html

Kadaga petitioned over maternal deaths

By Umaru Kashaka

Publish Date: Aug 08, 2013

KAMPALA - A coalition of over 40 civil society organizations, united in the fight against preventable maternal and child mortality in Uganda, mid-this week petitioned Speaker Rebecca Kadaga over the crisis of maternal deaths in the country.

Samuel Senfuka presented the petition in the Speaker’s boardroom on behalf of the coalition before holding a vigil of prayer within Parliament for the late Remmie Wamala, a victim of maternal death.

Senfuka, from White Ribbon Alliance, called on Parliament to show its commitment to correcting the crisis through concrete action of increasing investment of sh43.5bn in wages for midwives and other critical cadres.

“We congratulate you for prioritizing health workers in last year's budget through sh49.5bn investment in the recruitment exercise that has deployed thousands of new health workers to health centers IIIs and IVs,” he said.

But he was quick to add: “But Parliament’s work is not done. Without sh43.5bn to enhance pay at local gov’t health facilities, these health workers will simply give up, leading to massive societal and financial waste.”

We must not allow Wamala’s death to be in vain or the thousands of other Ugandan women who, like Wamala, die preventable deaths while giving birth, he pointed out.

Wamala, who was the coordinator of the Uganda parliamentary forum for children, died recently while giving birth at International Hospital Kampala (IHK) of excessive bleeding and a ruptured uterus. 

Her death brought into sharp focus the issue of maternal mortality in the country.

Senfuka said the financial year 2013/2014 budget should prioritize wage enhancement for midwives and other health workers, improve oversight of healthcare, and expand pre-service training for health workers.

“Some of our health facilities are becoming no-go zones for pregnant women and the ultimate responsibility of monitoring them by the health ministry is too weak,” said Mable Kukunda of Uganda National Health Users'/Consumers' Organisation (UNHCO).

The petitioners called on the Legislature to intervene and impose a system of strict oversight so that preventable deaths trigger urgent investigation and action.

“And maternal death audits result in policy change rather than merely reports that sit on shelves,” Kukunda added.

The coalition also called for expansion of pre-service training for health workers in scarce supply, including midwives, lab anesthetists and the public health nurses over the next three years.

This, they reasoned, would enable the health workers offer maternal health services within their health facilities while additional midwives are produced in their training institutions.

Source: http://www.newvision.co.ug/news/645883-kadaga-petitioned-over-maternal-deaths.html