Uganda’s steady progress in advancing maternal and child health outcomes

In recent years, Uganda has made remarkable strides in improving Maternal and Child Health leading to healthier families and communities.

Through concerted efforts and strategic interventions, the country has witnessed a significant reduction in Maternal and Child mortality rates.

Dr. Richard Mugahi, Acting Commissioner for Reproductive and Child Health at the Ministry of Health, emphasizes these advancements, citing a decline in maternal mortality rates to 189 per 100,000 live births.

However, challenges persist in achieving the ambitious target of less than 70 maternal deaths per 100,000 live births by 2030.

Dr. Mugahi further underscores the positive trend in child and infant mortality rates, with infant mortality decreasing from 27 to 22 per 1,000 live births. He attributes these improvements to increased access to reproductive health services and antenatal care.

“Over 95% of women now attend at least one antenatal visit, and 72% attend at least four visits. Despite these gains, the challenge of women delivering under unskilled birth attendants remains, contributing to pregnancy-related complications and deaths” he said.

To address these challenges, the Ministry of Health is implementing strategic interventions outlined in Sharpen Plan 2, focusing on reducing maternal and newborn mortality.

Initiatives such as Maternal Perinatal and Death Surveillance and Response, alongside the establishment of high-risk pregnancy clinics in all health facilities nationwide, are key components of this plan.

Dr. Mugahi stresses the importance of partnerships with other departments and international organizations in effectively implementing these interventions to achieve sustainable outcomes in the progress in Maternal and Child Health.

In an interview with Dr. Emmanuel Byaruhanga, Director of Kawempe National Referral Hospital, he discusses the hospital’s specialized services and the challenges it faces. “These challenges include late referrals and congestion due to limited infrastructure” he noted.

However, Dr. Byaruhanga highlights notable successes in reducing Maternal and Child mortality rates by 30%. He mentions that 8 mothers would die weekly in the past, compared to now when only 3 mothers die per week.

He expresses gratitude to the Ministry of Health for supporting efforts to address gaps and improve healthcare delivery. This support has led to improvements in blood supply management and infrastructure enhancements.

Dr. Byaruhanga also discusses’ ’the elimination of absenteeism among health workers at Kawempe National Referral Hospital, highlighting improvements in system efficiency and patient care”. Through innovative approaches like Quality daily meetings on Zoom, healthcare professionals collaborate effectively to address challenges and ensure quality care delivery.

In October 2018, His Excellency the President of Uganda, Gen. Yoweri Kaguta Museveni commissioned the Mulago Specialized Women and Neonatal Hospital in Kampala.

This 450 bed hospital provides advanced services such as: high risk antenatal care, delivery, postnatal services, neonatal services, gynaeco-oncology, uro-gynaecology especially focusing on obstetric fistula (VVF), assisted reproductive health technologies, high risk pregnancies, complex fistula surgeries among others.

The hospital aims to decongest Mulago National Specialized Hospital enabling women with reproductive problems and new borns who are born prematurely to be treated from Uganda rather than abroad. For instance, the dedicated team at the Neonatal Intensive Care Unit at this facility has realized the growth and development of babies born weighing as low as 500gms to fully grown and healthy infants.

An interview conducted with Dr. Evelyn Nabunya, the Director of Mulago Specialized Women and Neonatal Hospital, revealed the significant progress in maternal healthcare.

“We’ve witnessed a remarkable 58.8% reduction in hospital maternal mortality from 2019 to 2023,” she said. Emphasizing the hospital’s commitment to improving outcomes for preterm babies, Dr. Nabunya notes “The lowest surviving preterm baby born at 24 and a half weeks, weighing merely 500 grams, is thriving at one year and nine months.”

Regarding the hospital’s initiatives in improving Maternal and Neonatal care, Dr. Nabunya highlights, “Establishment of specific committees like the medical equipment committee, training committee, and research committee has been instrumental in driving quality improvement.”

She also emphasizes the importance of continuous improvement, stating, “Daily clinical audit meetings provide an avenue for teams to discuss difficult cases and share best practices, ensuring ongoing enhancement of healthcare delivery.”

Looking forward, Dr. Nabunya stresses the importance of streamlining the referral system, stating, “Further streamlining the referral system and integrating healthcare information systems are critical for advancing maternal healthcare.”

The journey towards better maternal and child health in Uganda is a collaborative effort, with healthcare professionals, government agencies, and international partners working hand in hand to overcome obstacles and improve healthcare outcomes. Through continued dedication and innovation, Uganda is steadily moving closer to achieving its goal of healthier families and brighter futures for all.