Lira health centres rely on rain water – WRA Study

By Patrick OkinoPublish Date: Dec 22, 2013
Source: http://www.newvision.co.ug/news/650759-lira-health-centres-rely-on-rain-water-study.html

Serious water and power shortages in health facilities present a massive problem in labor wards in Lira district, where birth attendants are forced to use phones and lamps at night during the process of child delivery.

A study by White Ribbon Alliance (WRA), an NGO, found that health facilities rely on water from the wells, boreholes and also rain water.

Among the health centres involved in the survey were Bar, Aromo, Amach, Agali, Ongica, Barapwo and Ober in Lira.

The report revealed that none of the health centres involved in the study had running water, a huge constraint to the flow of activity in the centres.

Absence of piped water therefore means infection control is greatly constrained.

In five out of the nine health centres surveyed, workers reported using personal mobile phone torches as backup for lighting during delivery of mothers at night.

Two birth attendants said they used hurricane lamps and three admitted they had no form of power backup.

The project manager, Senfuka Samuel presented the report to Lira regional referral hospital at the close of this week.

Lira district speaker, Ocen Odyek, LC3 chairpersons, sub-county chiefs, district councilors and health workers attended the presentation of the report.

Six of the health facilities harvest rain water for regular use, seven use boreholes while others rely on wells or hire people to collect water for them, revealed the report.

One midwife from Bar health centre, Betty Akullo said they risk getting infections any time because of shortage of water in the delivery ward.

Acute shortage of water and power at the lower levels is putting more pressure on the referral units.

Senior principal nursing officer at Lira regional referral hospital, Petrua Kiboko says patients are overwhelming referral units in the region because of the problems at the health centres.

The main hospital too runs out of the power sometimes, and has to use generators as backup, with a consumption of about 24 litres per hour.

LIRA COMMUNITY MEMBERS PETITION THE DISTRICT COUNCIL OVER LOW LEVEL OF EMERGENCY HEALTH CARE SERVICES FOR PREGNANT WOMEN

Patrick Ogwang

WRA Uganda (WRA Lira District Media Coordinator)

Tommy Ojan Egits presenting the petition at Amach Sub-county headquarters 
during  Lira District World AIDS  Day commemoration 

White Ribbon alliance Lira in collaboration with residents from the two sub county of Ogur and Amach petitioned Lira District Local Government to allocate a budget in the financial year 2014-2015 to support Emergency obstetric and newborn care services at health center s III and IV. The petition signed by over 1000 community members was presented to the District Council through the District Speaker.

While handing over the petition to the district leaders at the commemoration of World Aids Day district event at Amach sub county headquarter, Tommy Ojan Egit who is a WRA Lira member and newly elected representative at the WRA Uganda board said that the petition followed an assessment by White Ribbon Alliance, leaders and community members carried out in all the health facilities at level of III and IV in Lira with the indicator that none of the two HC IVs is able to provide comprehensive emergency obstetric and newborn care services due to theater functionality issues.

Ojan further stressed that shortage of running water, power and non-functional theaters at Ogur and Amach HC IVs, stock-outs of injectable drugs for basic obstetric complications, inadequate resuscitation devices, lack of blood pressure machines and incomplete delivery instruments among others has put the lives of pregnant women and their newborns at risk since most of them are referred to the main regional referral hospital which is far away from them.

Tommy Ojan Egits handing-over EmONC petition to Lira District 
Vice Chairperson at Amach Sub-county headquarters

“The petition requested the district officials to allocate sufficient funds for emergency care services in the financial year 2014-2015 in an attempt to reduce the death rate of women in childbirth. The White Ribbon Alliance is not an NGO but Alliance whose aims are to advocate for safe motherhood.” Said Tommy

Mr. Andrew Ogwang Oyang the District Vice Chairman and the leader of government while receiving the petition on behalf of the District Speaker and the council thanked The White Ribbon Alliance for their effort of carrying out an assessment saying it has helped a lot the district to get documented information for planning. The Chairperson promised to handle the petition with urgency it deserves so that the issues raised are considered in the district budget.

Subsequently, on 6^th December 2013, The White Ribbon Alliance members held a meeting with the members of the district committee for health and education to further advocate for prioritization of emergency obstetric care services in the district budget. Mr. Moses Ogwang Adonyo the Chairperson of health and education committee said that his committee will make sure the report findings are brought to council for further scrutiny and approval so that a budget is allocated in the financial year 2014-2015.

WRA Lira and community members march during World AIDS Day commemoration
event at Amach Sub-county headquarters, Lira district before presenting their petition

The petition is part of a series of activities under the accountability campaign code named ACT NOW TO SAVE MOTHERS coordinated by The White Ribbon Alliance Uganda in three districts of Lira, Mityana and Kabale aimed at asking Government of Uganda to uphold its commitment of increasing comprehensive emergency obstetric and newborn care in all health centres IV from 17% to 50% and ensuring that basic  emergency obstetric and newborn care is available in all health centres before its target timeline of 2015. #ActNowToSaveMothers

ACT NOW TO SAVE MOTHERS

White Ribbon Alliance Members in Kabale Petition District Speaker over Low Status of Emergency Obstetric Care in the District

Members pose for a photo after presenting and handover a petition to Hon. Twinomuhangi Pastoli, Kabale District Council Speaker at his office.

By Robert Muhereza

WRA Kigezi, Media coordinator

Today December 2, 2013 White Ribbon Alliance Uganda-Kabale district and community members joined by district councilors petitioned the District Speaker Hon. Twinomuhangi Pastoli on the LOW STATUS OF EMERGENCY OBSTETRIC AND NEWBORN CARE SERVICES IN KABALE HEALTH CENTRES IV AND III. After the damning findings of the health facility assessment of emergency obstetric care status conducted by White Ribbon Alliance, District Health Office, community members and leaders, members are asking their district council and leadership to prioritize funding for EmONC in FY 2014/15.  The Speaker pledged to table the petition before the district council for discussion and consideration of the issues contained in the petition.

Members will meet the district Standing Committee of Health to discuss further and advocate for prioritization of making theaters at HC IVs function. All the 7 health centre IVs of Kabale do not provide C-sections and blood transfusion due to lack of medical officers. 

Join WRA advocacy campaign in Kabale to Save the lives of many pregant women in Kabale- #ActNowToSaveMothers 

Accessing Services at Ogur Health Centre IV: A Journey into Hell!

For our esteemed visitors and readers of this blog page, Bill Oketch a Journalist based in Lango sub region treats you to yet another article about the status of life saving services at Ogur HC IV, Lira district. 

I hope those who understand Luo it will be provoking, insightful and swing you into a discussion and action.

Unreliable Referral System Make Poor Women Shun Delivering From Health Facilities

Compiled by Senfuka Samuel

bsenfuka@gmail.com

A patient being transported to a health centre using an improved "Engozi"

This is a community ambulance commonly used in the mountainous Kabale district, south western Uganda to transport patients and pregnant mothers to health facilities. It's an improved "Engozi" (a locally made stretcher), which has been traditionally used to transport sick community members through a community support system. It is now a push and pull ambulance unlike the stretcher where they have to get energetic men to lift the patient or a pregnant woman through the steep slope terrain to a health centre. On the White Ribbon Alliance for Safe motherhood (WRA Uganda) mission of health facility assessment of EmONC in Kabale district, we came across this on the way to Ikumba health centre III and the patient was being taken to  Hamurwa health centre IV, Rubanda East which was still about 16 KM away!

This makes the referral of pregnant women with complications and other patients a huge challenge to healthcare providers and a burden to the poor families hence women end up delivering from home or with assistance of traditional birth attendants because they can not afford referral costs. The situation is worsened by poor birth preparedness.

Join the Act Now To Save Mothers Advocacy Campaign by ASKING the Government of Uganda to uphold its commitment of increasing comprehensive emergency obstetric and newborn care (Cesarean sections and blood transfusion) to 50% in health centres IV and basic emergency obstetric and newborn care (treatment of hemorrhage, infections/sepsis, eclampsia, newborn resuscitation) in all health centres by 2015.

Citizens Voice and Experiences from Participatory Health Facility Assessment of Emergency Obstetric and Newborn Care in Mityana District

Compiled by
Senfuka Samuel
bsenfuka@gmail.com

"My name is Kigiongo Annet, a Village Health Team (VHT)/community health worker attached to Ssekanyonyi Health Centre IV in Mityana district. Our theater has been redundant for the past one year with no equipment making poor women who face complications to be referred to Mityana hospital, which is far away. I appeal to the government to urgently equip our theater and save women from long distances and losing their lives".

“If I were the President of Uganda I would ensure that midwives are deployed in all health centres that provide maternity services. I would also equip our theater with all necessary equipment and medicines that save women’s lives because women travel long                                                                distances to access comprehensive emergency care”

Scovia attending to a woman in labor

"I've worked here for 10 years. The most challenge I face is transporting women who are referred to Mityana main hospital about 40 km away. Most of these referrals happen at night but it is very difficult to get transport at night. We are always worried on duty when you refer a woman and cannot meet her transport costs. We end up using personal money to pay for women who fail to meet their transport costs. We request the government to functionalize the theater to save us from these challenges. Our health centre relies on solar power but it is down. We have a generator but there is no fuel to run it due to inadequate primary health care funds given to the facility. As a midwife I improvise and use my home lantern or a telephone torch." Laments Scovia Namaganda a midwife at Kyantungo Health Centre IV Mityana district.

 

Poorly designed main entrance into 
Kyantungo theater 

Doctors say that despite being fully equipped, Kyantungo Health Centre IV Theater requires urgent renovation in order to start any surgery work.

Mr Bernad, Chief Kalangaalo sub county

Mr. Tunankye Bernard, Chief, Kalangaalo sub-county Mityana district while at Kyamusisi Health Centre said: “As a sub-county chief, there things I have known today which need quick attention. It is not acceptable to have a water tank to the maternity ward and there is no water flowing directly to the labor ward. The In-charge should put it in writing and I go with the letter for immediate action. The In-charge of maternity together with In-charge of the facility should make a budget for kerosene for both the maternity lantern and boiling delivery instruments and submit it to me for review. The In-charge should write a formal complaint about the non-function new solar installation and I follow it up with the district officials. This is the only source of power to this facility, it should work. I thank White Ribbon Alliance for this                                                   assessment because it has showed us many things which we would not                                                   have known”

Harriet Nkugwa SNO Mityana hospital

Sister Harriet Nkugwa a Senior Nursing Officer at Mityana Hospital who was one of the technical lead during the health facility assessment of EmONC shared her experience: “This assessment has been very enriching and empowering far better than the way we have been conducting support supervision as district health team. It has helped us to discover many things and some have been upsetting. I am a member of the District Health Team but the way we have been conducting our support supervision and monitoring is shallow as compared to this assessment. We just go and sit with a health worker for a few minutes and proceed to another facility without physically checking on different departments and services. We are going to use this assessment tool to update ours and strengthen our supervision” 

“This has been a unique approach and it has helped to bring us together for collective action. Bringing health workers, political leaders, community members and the media for a common goal is important. We have been blaming one another for the poor service delivery but now we have realized that each one of us has a role to play. We need each other if we are to improve life saving services for our mothers” Sarah Katumwa, a midwife at Kyamusisi Health Centre and Chairperson WRA Mityana district.

Participatory health facility assessment of EmONC status at Kyantungo HC IV, Mityana District