Joshua Nahamya
13 March 2025
Mbarara City – A few days after the celebration of Women’s Day across the globe, the Ministry of Health [MOH] has launched a campaign to end mother-to-child death in Uganda.
While launching the safe birth initiative at Mbarara Regional Referral Hospital [MRRH], Dr. Godfrey Mugyenyi, an Obstetric and a Gynaecologist who is also the chairman of the national safe motherhood campaign in Uganda, said that this comes at a time when the whole world is grappling with the increased maternal death.
According to Mugyenyi, maternal mortality is number 8 in causes of death in the world while number three in sub-Saharan Africa most especially in low-income countries like Bangladesh among others.
“In 2020 alone 4.5 million deaths occurred globally [About 300,000 women died globally], 2.3mln neonatal deaths, 1.9mln stillbirths, and the majority of about 60% deaths occur in low-income countries” adding that, if we reduce maternal death in low-income countries by only 50 percent then the global picture will be different,” Mugyenyi said
Mugyenyi said that Uganda has so far reduced maternal deaths from 336 to 189 in 2022, thus challenging medics to reduce the cases to 70 deaths to be able to meet the SDG 2030 target.
“We are currently at 189 but we are excited for a good trajectory because we were at 336 in 2016 but Tanzania did better. In the same period they jumped to 104 and they are targeting about 70 per 100,000 maternal deaths in 2030”
Sr Peruth Mwesigwa, former midwifery at MRRH and current Senior nursing lecturer at Bishop Stuart University. Joshua Nahamya
Between 3rd and 9th February 2025, Uganda has already lost 98 women as a result of maternal mortality. “Within the first 6 of the year, we have already killed 98 women, that is an average of 11 women per week, and 326 perinatal deaths occurred in one week. As medics, we have actively participated in killing mothers because they are dying within our hands as professionals and we need to take this responsibility.” Mugyenyi stated
Causes of maternal deaths in Uganda
Hemorrhage [45%], hypertensive disorders [16%], preeclampsia, and among other indirect causes stand at 11 percent.
Dr Mugyenyi challenged the Ministry of Health to deploy the labor care guide in health facilities to be able to avert the increasing maternal mortality rate in Uganda.
The Labour Care Guide (LCG) is a tool designed to help healthcare providers monitor the well-being of women and babies during labor, identify any deviations from normal, and facilitate shared decision-making for a positive childbirth experience.
“We need a systematic review with issues pertaining maternal health to be able to detect and diagnose a case of obstructed labour, a ray of hope for the desired results.” Mugyenyi noted
According to Assoc. Prof Musa Kayondo, head of the department of obstetrics and gynecology at MRR, said cases of maternal deaths reduced from 72 in 2022-23 to 49 in 2023-24, and the number of babies who died during birth also reduced from 492 to 361 in Ankole sub-region.
“When we talk about safe birth every day we deliver about 35 mothers, I think this department is the safest place you can deliver not only do we handle the safe birth but also the capacity to handle complicated cases.” He said
Agnes Chandia Baku, Commissioner in charge of Nursing and Midwifery at the Ministry of Health in Uganda. Joshua Nahamya
Other challenges
Kayondo urged the Ministry of Health to increase the number of midwives at Mbarara main hospital to address the issue of persistent low staffing to be able to reduce maternal mortality at the facility.
“When I talk of human resources, I want to emphasise the issue of midwives. We have a total of 19 midwives including those on study leave so you wonder how these 35 women were delivered by two people on duty”
He also reported that the referral hospital is battling with infrastructure issues thus appealing to the ministry to provide a maternal and child health services [MCH] building like any other regional hospitals like Jinja, Kabale, and Hoima.
“We deliver 35 mothers a day but we only have a post-delivery ward of 45 beds. People even compete for the floor on the postnatal ward; it also means premature discharge of patents before they are ready because of lack of space”
“I think we are the only major hospitals right now without an MCH building if you go to Jinja, Kabale, and Hoima. It is quite a challenge trying to deliver 35 women a day with such limited space; we also need an ICU and HDU within the department. We face serious challenges with some of these mothers to get space in the ICU in the hospital which is limited.” Kayondo noted
Assoc. Prof Joseph Ngonzi, Dean Faculty of Medicine at Mbarara University of Science and Technology [MUST], challenged medical students to invest in resourceful research that will be able to produce alternative solutions to health issues.
“As a scholar, and a clinical care provider, experience is gained in research but we need to translate research into practice. You can do lots of research but when it is not put into practice, you are not impacting the world” Adding that, championing old knowledge does not offer patients the best care.” Ngozi stated
Dr Alex Rutebwa, Assistant City Health Officer [ACHO] Mbarara City said that health levels in Mbarara City stand at 20 percent and midwifery at 34%.
“In other words, out of 70 midwives we are supposed to be having in Mbarara city, we only have 24. You can imagine the labor department of obstetrics at the entire referral they have only 19 midwives at least there should be a special consideration to some of these cadres to have at least more midwives to ensure quality health care we are talking about,” Rutebwa emphasized
He added that the issue of medical supplies is challenging patients in government health facilities.
“People are tired of being told to go and buy things. It is a very complex issue, it is an emergency caesarean section, and you don’t have gloves, a surgical blade. Let us improve on the supplies for the care of our mothers.” Rutebwa noted
Akim Twinamatsiko, assistant RCC Mbarara city south division, said that maternal mortality and birth-related complications remain a big challenge in Uganda, thus a call to the government to prioritize maternal and child health by making significant investments in infrastructure development.
“In Uganda, many women still lose their lives while giving birth and many new-borns don’t see their birthday which the government should focus on.” Twinamatsiko noted
Agnes Baku Chandia, Commissioner in charge of Nursing and Midwifery at the Ministry of Health, warned health workers to stop being careless while attending to patients. She also appealed to them about the issues of extortion which she said would kill their profession.
“It is my call to all of us here to be ready to let go of things that don’t work and embrace things that matter irrespective of whether you are at the forefront or not,” Chandia noted
“Doctors will always want to be called on the phone. Who brought, up that doctors should always be called on the phone? Why should you be called on the phone? You should know that you are a responsible person. And you are part of the team. It is very awkward; you should learn to work as a team. You have operated on a mother and you know that she has undergone through obstructed labour. Why can’t you spend one hour working together to see this woman transiting through the difficult part? She stated
Chandia also encouraged medics to emphasize patient-centered care to save them from maternal death.
“Can we start preconception, take time to assess the mothers, emphasise peripheral assessment. We are the proprietors for these facilities. Can we let our profession be respected, can we let our patients be at the centre.” She explained
Safe birth initiative is a nationwide landmark that calls for individual and corporate engagement with all players in the healthcare system to reduce mothers dying during childbirth.
