Saving the Mother and the Newborn

THE HealthIssue 08 December 2016 Digest SAVING THE MOTHER AND THE NEWBORN FOOD The first 1000 days BABIES The three common killers REFERRAL Back to the basics Inside this issue 1. Table of contents ....................................................................................................................... Page 1 2. Message from the editor .......................................................................................................... Page 2 3. Letter from Save the Children ........................................................................................................ Page 3 4. What does the mirror say? ............................................................................................................... Page 4 5. The three common baby killers ............................................................................................ Page 15 6. Good feeding generates good baby health .............................................................................. Page 18 7. We need a stronger referral system ............................................................................................. Page 21 8. Saving Uganda’s mothers and newborns ....................................................................................... Page 24 9. Customer care at hospitals .............................................................................................................. Page 26 10. Hard to reach: Busanza in Kisoro ........................................................................................... Page 29 11. Remoteness problem in Hoima ............................................................................................ Page 32 12. Gains for mothers and newborns .................................................................................................... Page 34 13. Counting the dead: Will it be helpful? ............................................................................................. Page 36 14. Why mothers still vote for TBAs .................................................................................................... Page 38 15. Good policies but dismal performance .......................................................................................... Page 40 16. Reducing deaths by 2030 ................................................................................................................ Page 43 To buy this copy at Our advertising rates are as below (inclusive of 18% VAT); SHS 7,000 or US$ 3, Size Call: 0704 292188 Full page 3,600,000 0712 685837 Half page 1,800,000 0703 826623 Quarter page 900,000 For advertising, contact Bagenda Elliot on 256 712 685837 Editor’s Message Executive Summary We know what should be done; let us do it and do it right Every day, 16 women die in Uganda from pregnancy and childbirth- related causes, 94 babies are stillborn and 81 newborn babies die. This Child birth is usually a major event in every family in Uganda. equates to 69,570 deaths each year due to complications during preg- The anticipation and excitement! The implication of worth in so- nancy, childbirth and in the first month. ciety! The expectation of a new member! All these build up with every one of the nine months. Many of these deaths are from causes that are largely preventable, with So, when the baby or the mother dies, it becomes a big plunge maternal deaths caused by four major factors – haemorrhage/bleed- from expected celebration to hurtful mourning and a haunting ing, hypertension, unsafe abortions and sepsis. Babies die mainly due pain. to complications of prematurity, complications at birth and neonatal infections. Yet it is within the means of modern society to ensure safety for mothers and their newborns. But our health system, social support, Government priorities, and individual beliefs and choices It is a fact that access to a trained health care worker, along with basic Editorial Team still keep pregnancy looking like a battlefield from where the medicines such as antiseptics and antibiotics, vital equipment and a mother may not return. clean environment to work in, can save the lives of nearly-born and Managing Editor newborn babies. However, only 57% of births in Uganda occur with the Esther Nakkazi The Health Digest reveals how most deaths are preventable, how in- support of a skilled health care worker and many health facilities are vestment in maternal and newborn health needs to be improved under-equipped and under-staffed. and how solutions need to come from multi-disciplinary and in- Editor: ter-agency strategies. For example, while Health needs to improve Hilary Bainomugisha services, Education needs to give us properly trained health pro- To stop women and babies dying unnecessarily during labour, birth viders and keep girls longer in schools while Agriculture needs to and the first day and week of life, key changes in the delivery of basic Senior Consulting Editor: facilitate better nutrition and food security. Works need to ensure healthcare are urgently needed. The Government of Uganda has com- Christopher Conte accessibility of health facilities, Energy for electrification espe- mitted to ending preventable maternal and newborn deaths by 2030 cially of rural areas and Gender for social mobilisation and sensi- as part of the Sustainable Development Goals and the Every Newborn tivity while Finance needs to ensure adequate budgets for Health. Contributing Writers: Action Plan. National policies and strategies are in place, such as the HEJNU Team Guest writers Most of the situation The Health Digest covered show that most National Roadmap for Maternal and Newborn Survival. maternal and newborn deaths can be prevented at four levels of intervention; individual, community, institutional and Govern- Design/Layout The voices for Uganda’s newborn babies and their own rights needs to Bagmuz Creations mental provision and supervision. be amplified by parents, communities and health workers in order to hold Government, donors and others accountable to these commit- Our findings suggest that, although we are not there yet, we are Send all correspondence to: in the right direction. It is as much a Government duty as it is an ments. Plot 156-158 institution, a social and an individual role to make it better. Any Mutesa II Road, Ntinda P. O. Box 4883 false step by any of the stakeholders frustrates the entire system. Save the Children has worked with the Health Journalists Network of Kampala -UGANDA We know what is right, we should do it. Uganda to compile articles on newborn and maternal health, which, we Tel: 256 704 292188 hope, will expose the various challenges that communities (especially [email protected] We thank our funders and developmental partners, especially women) face in seeking health care, as well as the efforts in place to Website: www.hejnu.ug Save the Children, for their efforts in ensuring that each mother comes out alive and with a healthy baby. mitigate them. 2 The Health Digest The Health Digest 3 Uganda’s Health news leader Uganda’s Health news leader and Tanzania respectively according to UNFPA. Who can better appraise maternal and child health services in Uganda than the direct users? A team of journalists visited selected centres in Isingiro, Kiboga, Kukiriza’s mother complained about the delays after Mukono, Buduuda, Adigo, Mbarara and Sembabule. They talked to users and they got to Rwekubo health centre saying they arrived providers of health services about what needs to be done to make it better. in the night but her daughter was only taken to theatre at 10am in the morning, six hours later! But according to the in-charge, Dr Gamukama Tuhaise, specific theatre procedures have to be followed before a patient is taken for a caesarean section; blood type established, vitals taken, theatre cleaned and prepared, fuel for the generator bought and the lone anaesthetist called in. The health centre IV has one oxygen point, no running water, a few health workers and no electricity. Once a week a truck delivers water for use. The generator sometimes jams. And the only anaesthetist has to be called on demand because he cannot stay on standby TEEN PREGNANCIES: A 13 year old who gave birth in Nebbi when he is needed elsewhere. IV. The teen mothers seem unperturbed and try again quickly. He said preparation of the theatre takes about 40 min- utes and although Kukiriza’s baby was alive at delivery, “It does not affect them much,” said Gamukama. “One it died a few hours later from exhaustion. year later, they will be back here. They are usually pregnant within the next three months after losing a baby.” Mothers at an immunization centre in Mbale “Efforts to resuscitate it did not yield much partly be- But why? cause these women take herbs they believe will enhance smooth delivery. The herbs instead thicken the fluids, “Maybe it is a psychological urge to fill the void im- which get logged in the baby, making it difficult it to mediately, or stop the scorn and stigma by village com- What does the mirror say? resuscitate it,” said Gamukama. munities who are likely to talk about ‘the daughter of so and so who has failed to bear a child for our son.’But Teenage pregnancies dog Isingiro Asked which particular herb was responsible the doctor there is also prestige in switching names to ‘mama boy’ or whatever name the first born child bears and merely By Esther Nakkazi said he did not know but advised women to stop taking herbs when pregnant. just to prove themselves,” a nurse explained. In

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