The government has over the years rolled out a number of initiatives to improve maternal health in the country and today Dr. Joyce Moriku Kaducu, the minister of state for health in charge of Primary Health Care, offered an update.
Maternal Health is the health of women from the time of conception, through pregnancy, childbirth, and the postpartum period (6 weeks after childbirth), according to the health ministry.
Minister Kaducu in a Friday news release noted that Uganda has made progress in boosting Maternal Health Services, especially in rural areas where over 300 health center IIs have been upgraded to health center IIIs.
The ministry has also facilitated the implementation of high-impact interventions around the time of labour and childbirth.
“This has led to reduction in maternal mortality from 448/100,000 LB (UDHS 2011) to 336/100,000 Live Births (UDHS 2016) [‘An updated survey will be done this year’],” she said. “We have registered improvement in the number of women attending the first Antenatal Care to 95% but those completing at least (04) Antenatal Visits remains low at 42%.”
To keep the growth curve positive, the government has prioritized a number of interventions as shown below: The ministry has introduced emergency obstetric care to address the major direct causes of maternal death, namely: hemorrhage, sepsis, unsafe abortion, hypertensive disorders, and obstructed labor. The listed cause about 80% of maternal deaths.
The ministry has also ensured that there’s skilled attendance at birth to help detect and manage complications. “It also ensures appropriate referral for the further management of these complications,” the minister said, adding: “The government is ending preventable maternal deaths by recruiting more skilled health professionals in lower health facilities and hospitals. The government also provides a supportive environment for the staff by investing in infrastructural development. Government of Uganda is investing in equipment for health facilities in order enable the staff works well and offer quality care.”
By supporting both modern and natural family planning, the government is preventing unintended pregnancies. Family planning can also promote Uganda's economic growth by reducing the economic dependency ratio, the minister said.
The health ministry is also implementing antenatal care which can prevent, detect, and treat problems such as malaria, anemia, HIV/AIDS and other infections, which frequently are indirect causes of maternal deaths.
To reduce teenage pregnancy, the government is finalizing the policies involving adolescent and school health policy which are at the final stages.
The government has also established Neonatal Intensive Care Units (NICUs) and is planned for High Dependency Units in all hospitals.
It is also implementing maternal and perinatal death reviews (MPDR) which provides a platform to identify potentially modifiable factors and developing strategies to address them.
Despite the efforts, the government says there are still major challenges that need to be addressed like poor understanding of complications and risk factors in pregnancy, long distances to health facilities, poor road network, inadequate equipment, inadequately trained staff, lack of motivation among staff and so on.
“Maternal mortality is also still a big challenge especially among the teenage mothers who contribute approximately 18% of all maternal death. Teenage pregnancy is also still high at 25% national average but in some regions, we have 30% and this has even worsened during the COVID-19 pandemic,” the minister said.
“the most common direct causes of maternal injury and death remain; excessive blood loss during childbirth, high blood pressure during and after pregnancy, unsafe abortion, especially among the young women, is the leading cause of death at 22%, obstructed labor leading to rupture of the uterus, other Indirect causes such as anemia, malaria, and heart disease among others.”
According to the minister, bleeding (hemorrhage) is the leading cause of death contributing 42% of all death reviewed and 90% of hemorrhage is postpartum hemorrhage.
“36% of maternal deaths occurred among young mothers <24 years who should have been in school. Teenage pregnancy contributes up to 17% of all maternal deaths.”
Maternal and Child Health (MCH) is a key indicator for measuring the development of any nation including Uganda, the minister said.