MOTHERHOOD, LEAVING NO ONE BEHIND

MOTHERHOOD, LEAVING NO ONE BEHIND

Article as published in New Vision October 28 2021

Re-printed with permission from the author: Mr. Martin Lubega

Pregnancy and childbirth are special events in every woman’s life, and, indeed, in the lives of their families. To many, these may be moments full of hope, excitement and joyful anticipation. However, this can also be a time of fear, suffering and even death for many women and newborns. We must be reminded that pregnancy is a normal stage for every woman, not a disease although it is associated with a number of risks that threaten the health and life of both the woman and the unborn baby.

These risks exist in every society and in every setting. In the developed countries the risks have been largely overcome by ensuring that every pregnant woman has access to quality health care services during pregnancy and childbirth.

Such is not the case in many of our developing countries including Uganda where pregnancy continues to end the lives of many women across the country while others walk through with serious morbidities affecting their physical and sociocultural functionality. Over years, Uganda has registered great milestones in creating a health care system that is responsive to the health care needs of women and children based on the six core pillars of safe motherhood. These include Family planning, antenatal care, obstetric care, post-natal care, post-abortion care and control of sexually transmitted diseases including HIV.

The government of Uganda and its development partners have invested resources in improving access to quality maternal and child health care services for all women all throughout pregnancy as a strategy to reduce maternal and neonatal mortality and morbidity. It is worth noting that between 1971 and 1986, Uganda’s health care system suffered unprecedented setbacks due to poor leadership and internal conflicts.

Therefore, the NRM government inherited and embarked on rebuilding a shattered health care system. For example, by 1988, Only 37% of pregnant women would deliver at health facilities; 3% of the women were using modern family planning methods; only 38% of children received full immunization and the maternal mortality was at 527death for every100,000 live births.

Despite the existing challenges in the health sector today, there is free access to basic and emergency maternal and child health care services in public health facilities across the country. The maternal and child health indicators have also greatly improved. For example, by 2016, over 73% of the women were having deliveries from health facilities, under-skilled health workers, the childhood immunization coverage is reported at 99%, over 35% of the women are using modern family planning methods and the maternal deaths have gone down to 336 deaths per 100,000 live births.

The routine countrywide distribution of mosquito nets has also greatly reduced the number of maternal deaths due to malaria in pregnancy.

Access to maternal and child health services has also greatly increased due to newly constructed health facilities across the country. Mulago Specialised Women and Neonatal Hospital that provides high specialized maternal and child health care services is one of those magnificent achievements of the government in its efforts to promote Safe motherhood in the country.

Yes, as a country, we have registered all this progress, but we still fall short of our expectations and targets as stated in the recent National Health Sector Strategic plans. A lot ought to be done to boost the quality of services in these health facilities.

On many occasions, there are outcries of stockouts of essential medicines and supplies resulting into delays in providing care. These shortages and understaffing of midwives and doctors across the country must be addressed to ensure equitable care for all women across the country.

The biggest proportion of the skilled birth attendants are concentrated in the urban areas, yet the biggest percentage of the country’s population lives in rural areas. Who is there for such mothers?

We must act now. Many facilities across the country do not have ambulances to effect timely referrals and this has resulted in maternal deaths. This year’s theme citing “leaving no one behind” ignites us to think about those women in the hard-to-reach districts, those districts without district hospitals that can provide immediate emergency obstetric care when needed, those women on the Kalangala islands that have to wait for the common ferry to access referral services from health facilities in Masaka and Wakiso districts.

It’s so exciting to learn about the government’s plan to introduce the Parish Model for economic development. How about if we thought of something similar to improve maternal and child health services in the country.

Communities play a very important role in their own health promotion thus the need to empower them to implement primary health care services like immunization, antenatal care, family planning and promotion of utilization of basic maternal health services and health facility deliveries.

Our Village Health Teams (VHTs) should be empowered to provide basic services and to initiate referrals from communities to health facilities by building stronger partnerships between VHTs and other health workers and regularly providing them with supplies and transportation allowances.

The raising number of teenage pregnancies amidst this COVID 19 pandemic poses yet another challenge in attainment of safe motherhood. This calls for own action to provide youth friendly sexual and reproductive health education and to promote contraception use in this age group.

Many of the teenage mothers still face untold stigmatization that they can’t even come out to access antenatal care services for fear being ridiculed.