Joshua Nahamya
26 November 2024
Mbarara City – Medics at Mbarara Regional Referral Hospital (MRRH) have asked the Ministry of Health to increase the number of nurses caring for preterm babies at the facility.
At Mbarara Regional Referral Hospital over 3000 sick newborns are admitted annually, and a third of these are born preterm.
Most of these tiny babies are highly susceptible to health-related problems such as respiratory distress syndrome, a medical condition associated with breathing making complications making it difficult for some to survive.
While commemorating World Prematurity Day on Friday, Dr. Elias Kumbakumba, Head of the pediatrics and child health department at MRRH, said they lack experienced nurses at the neonatal intensive care unit [NICU] ICU.
“Right now we are solving the space problem but our biggest challenge is nurses and without well trained nurses we cannot do much at the neonatal unit,” Kumbakumba said
He said the celebrations are meant to raise awareness across the globe that premature cases are increasing in Uganda thus calling for more support for both the babies and their mothers.
A 2 billion US dollar building under construction to house the NICU at MRRH.
“Babies get born too early and the number is growing” Uganda has about 1.6mln babies and up to 200,000 of those are pre-terms which require extra special care because they are very delicate since some are born at 6 months before they have like one kilogram, they cannot breathe, they can’t make their heat yet the world requires of them to exist,” Kumbakumba explained.
According to Dr. Kumbakumba, Mbarara Hospital has only 7 nurses taking care of 1200 preterm babies a year.
“Imagine one nurse managing 60-75 babies sometimes in 12 hours. It is an intensive workload for our nurses” We need a minimum of 30 nurses in the neonatal unit so that we are able to nurse the premature babies properly.” He said
Kumbakumba said that Mbarara Regional Referral Hospital takes care of 3600 babies every year out of which 12,000 are born prematurely.
Dr Stella Kyoyagala, the Head of Neonatal Intensive Care Unit observed that with USAID assistance, health workers at the peripheral facilities that feed into Mbarara Regional Referral Hospital have been equipped with lifesaving skills besides enhancing the referral system.
Kyoyagala said that out of 1200 total preterms received, 900 survived while 100 premature died due to a lack of enough nurses at the facility.
“Preterms contribute 60% of all newborn deaths and 40% of all deaths for children from birth to 15 years because of lack of nurses in this unit for preterm babies which has to be addressed,” Kyoyagala said
She appealed to the communities to know that preterm babies are also born so should not be stigmatized but rather supported to have life.
“These babies are born too small so they need a lot of resources even food because their mothers need food to produce enough milk but in most cases you find them starving since they run out of resources because of overstaying in the hospital taking care of their preterm babies.” Kyoyagala noted
Mothers are also encouraged to adhere to the Ministry of Health’s guidelines of attending at least eight antenatal visits throughout their pregnancy for proper monitoring as it gives an attending healthcare professional an opportunity to identify conditions that may lead to preterm deliveries for appropriate management.
Medics at Mbarara Regional Referral hospital join the rest of the globe to celebrate World Prematurity Day on Friday at Mbarara University Science and Technology grounds. Joshua Nahamya
Testimonies
Irene Atuhaire thanked medics at MRRH for enabling her 26 weeks premature to survive despite the challenges she encountered during the birth period.
“She was born at 26 weeks and I had to spend with her 76 days at NICU sleeping on the tiles but I thank god through the efforts of referral neonatal doctors that my child is now grown up,” Atuhaire said
She retaliated to the challenge of lack of space and nurses at the NICU appealing to the government to address those challenges.
“In NICU we used to find few health workers and at night we would suffer with our premature. So I request the government to increase the number of health workers in the NICU because more premature babies are being born today” And we also had a small space yet the mothers were many.” Atuhaire said
Betty Nuwagira is also grateful to see that her premature production at MRRH has so far completed primary leaving examinations [PLE].
“I was about seven months pregnant when I fell down while I was mopping and I started bleeding. I thought that was the end of my first baby but thank God I gave birth prematurely and we spent three months at the referral” Despite all those challenges I thank doctors and nurses to see that my boy has now completed his primary leaving examinations.” Nuwagira explained
She encouraged all the mothers who gave birth to preterm babies that they would grow and live like any other person so long as they sought medical support.
Nuwagira also decried the lack of space and enough nurses at the neonatal unit urging the government to improve the health services in the country.
Kairukye Mugisha Mbarara city health officer said that causes of premature birth are lifestyle diseases which can be prevented thus appealing to pregnant mothers to often seek medical care to prevent it from happening.
“Cause of babies being born too early are a number of things that could be avoided such as infections, genital tracts, lifestyle diseases like diabetes, hypertension, smoking, alcohol” So if someone becomes pregnant, should consider going for antenatal care some because some of those things that cause premature can be avoided,” Mugisha said
He also appealed to the government to equip NUCUs at lower health centers to improve the neonatal health care system to take good care of premature rather than congesting main hospitals with numerous referrals.
“When all health systems are working we don’t have to make the main hospital overwhelmed by numbers. So what we need to do as government is to functionalise the other NICUs at the lower level facilities such as health centre IIIs and IVs in this region by putting in enough health workers and installing them with equipment and drugs plus a workable standby ambulance system.” Mugisha said
Dr. Francis Oriokot, MRRH Deputy Director acknowledged that the issue of staffing is a general challenge worrying all the departments in the hospital.
“Currently our staffing rate is at 11.6 percent for essential staff in the hospital and our budget estimate for medicines, sundries and our essential health supplies stand at Shs 37bln, against a current budget allocation of Shs 2bln currently so partners please when we come to you don’t get tired keep supporting us.” Oriokot said
Margret Rwebyambu- Woman MP Mbarara district pledged to advocate for the increase of maternity leave for premature mothers through the parliamentary forum for maternal health.
“As members of the parliamentary forum for maternal health and the members of parliament who represent the workers, we are looking at how we can evoke the Act where a mother is given three months of leave when she has given birth to a preterm, twins, triplets or quadruple,” Rwebyambu said
“There is a time when the mother needs to be around the preterm baby because of deterring infections a reason I am coming out to advocate for more leave days for mothers who give birth to preterm babies, triplets, or quadruple babies,” she added.
Rwebyambu also pledged to influence the parliament to increase the wage bill in the Ministry of Health to address the understaffing issue in neonatal units which has haunted the referrals in the country.
“As parliament, when we increase the wage bill in the ministry of health we should consider the critical cadres who look after prematures.” She said
Dr. Deogratious Migadde, Senior Medical Officer at the Ministry of Health said that the newborn mortality has reduced to 22% per 000 despite the challenges of human resources both in terms of numbers and skills.
“The government has revised the staffing norm to include more health workers available in our health facilities which of course in most of the districts it has not been fully implemented so we continue with the advocacy role for increase of more funding and budget allocation for the health sector including one allocated for the staff you need,” Migadde said
He also noted that there is an issue of lack of data for the newborns at the national level thus appealing to the hospital officials to always share the information with the Ministry of Health for effective planning and budgeting.
“It has been a challenge right from the service delivery point whereby the babies do not even have the file, they just fix the babies’ information in the corner of the mothers’ file. This has gradually changed we need to recognize the new born as a client because we need quality data for planning,” Migadde said
He added that taking care of premature babies requires a collective responsibility thus calling upon the society to be part.
“Preterm care involves everyone, giving birth to a premature has a lot of social, psychological, and economic impact on the mothers” Besides on our side as health workers providing the drugs, oxygen, and feeding you don’t know what is going on with the mothers because caring for these preterms in the private units is very costly so we need to work with everyone to see that we achieve all our targets under this initiative,” Migadde said
Dr. Richard Mugahi, the commissioner in the Ministry of Health in charge of reproductive and infant health reaffirmed the ministry’s commitment to expand access to socially enabling healthcare services and ensure advocacy for adequate staffing equipment and infrastructure development.
“We very much know the challenges preterms face including challenges with breathing, infection feeding and maintenance of warmth so there is need to see that we work together to see that services that address each of these challenges are available everywhere and accessed by all those who need them”. Mugahi noted
According to Mbarara Hospital’s PRO Halson Tukamuhebwa Kagure revealed to this website that it’s estimated that MRRH delivers over 12000 mothers annually
Currently, it is estimated that Mbarara Regional Referral Hospital delivers over 12000 mothers annually.
Figures indicate that over the years, 20% of preterm were dying at the facility but the number has drastically dropped to 6%.
The milestone is directly attributed to the Ministry of Health and other development partners USAID through USAID Mbarara Regional Referral Hospital Strengthening Activity.
Dr. Deus Twesigye, Acting Hospital Director says the hospital’s Pediatric department has been equipped with critical lifesaving equipment such as patient monitors which enable health workers to offer quality services to the preterm.
Dr. Twesigye further noted that the government has installed a 100m3/hr volume is another step to restore hope among preterm mothers.
“Currently, piped oxygen is being extended to all wards including NICU to make oxygen available to every baby in need,” Twesigye said
World Prematurity Day is celebrated every year on 17th November and the theme for this year is “Over 13 million babies born prematurely every year. Access to quality care everywhere”
Statistics from the Health Ministry show that 38 percent of the 39,000 deaths occurring in the babies’ first 28 days are due to premature situations. This is because premature babies’ lungs are underdeveloped, which causes breathing difficulties, among other health problems, experts say.
“Statistics from the Health Ministry show that every year an estimated 15mln babies are born prematurely and of these over 1mln do not survive and in Uganda the preterm birth rate stands at 14% which translates to around 230,000 babies born too soon.” Mugahi emphasized
