By: Maria Jorgensen
Uganda has a high maternal mortality ratio,typical of many countries in sub-SaharanAfrica, with an estimated 505 maternal deathsper 100,000 live births.
The prevailing high rates of fertility (6.7 births perwoman), in an environment of poor access toquality maternal and neonatal care, havecontinued to expose Ugandan mothers andinfants to a high risk of death from pregnancyrelated causes, with an estimated 1 woman in10 dying from maternal causes in Uganda (thelifetime risk).
Some of the contributing factors to the highmaternal mortality rate in Uganda havebeen found to include:
Poor fertility regulation of early pregnancy inadolescents, short pregnancy intervals and a generallyhigh total fertility level. This has been in part due to anoverall low use of contraceptives .
Limited capacity of health facilities to manageabortion/miscarriage complications, despite it being amajor contribution to maternal morbidity andmortality
Of the 97 health units studied, only 40% were able tomanage the complications of abortion.
There was also poor service availability for post abortioncare, ranging from inadequate skills to lack of equipment,supplies and drugs in most health units ;
Prevalence of HIV/AIDS among pregnant women has alsobeen a factor in poor maternal outcomes. It is presumed thatthe prevalence of HIV infection peaked in 1992 for manyareas, then declined to its current level, estimated in 2001 tobe 6.1% of Ugandan pregnant mothers . According to onestudy, 26.5% are assumed to transmit the infection to theirbabies . Although AIDS continues to be a major healthproblem in Uganda, HIV incidence (new infections per year)does seem to be declining in parts of the country .
Malaria is one of the leading causes of morbidity inpregnant women but prevention and prophylaxis servicesare not well established .
POLITICALENVIRONMENT
Poverty reduction through improvinghuman capacity
National Programs
Safe motherhood Programme (SMP)
Builds supportive networks of birthattendants as a backup for maternal healthsystems
Bulilds interventions to determine high riskbirths
Strengthen referral systems
National Population Policy
Reduce fertility and maternal morbidityand mortality by:
Promoting informed choices,
Service accessibility
Improved care quality
National Gender Policy
Goal to integrate gender into nationaldevelopments.
Empower women through decision makingprocesses
National Policies
Universal Primaryeducation
Improve population literacy
Increased school enrollmentfor both boys and girls
Long term outcome ofincreasing the maternal andreproductive health of thatgeneration
Adolescent Health Policy:
promotes adolescentfriendly services, sexeducation and building lifeskills.
Forty-nine percent ofthe Ugandan poulationlives within 5 km of ahealth facility
33% of helath facilitiesin the country do notprovide maternityservices
Only 57% of hospitalswere equipped toadminister generalanaesthesia
The Ugandan Government needs to continue toimprove the health of it’s mothers in order tosilence this rampant problem.
Increasing access and quality of health care
Increasing sex education at both the youth and adultage groups
Increasing literacy
Advocate for pre natal and ante natal health careservices
The country has a high fertility rate,contraception use is low, and its population isone of the fastest growing in the world.
The maternal mortality ratio has declined by 36percent since 1990, but remains high.
The Government has made maternal and childhealth a development priority, and haslaunched a road map for the reduction ofmaternal and newborn mortality.
More must be done
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Jacobsen, K. H. (2014). Introducation to Global Health (Vol. 2). Burlington,MA, United States: Jones and Bartlett. Retrieved September 3, 2014
Ssengooba, F., Neema, S., Mbonye, A., Sentubwe, O., & Onama, V. (n.d.).Maternal Health Review Uganda. Makerere University Institute of PublicHealth, Health Systems Development Programme, 1-40. Retrieved 182014, September, fromhttp://r4d.dfid.gov.uk/pdf/outputs/healthsysdev_kp/04-03_uganda.pdf
(2011). The State of the World's Midwifery: Uganda. The State of the World'sMidwifery. Retrieved fromhttp://www.unfpa.org/sowmy/resources/docs/country_info/profile/en_Uganda_SoWMy_Profile.pdf
World Health Organization. (2012). World Health Statistics: Global HealthIndicators. World Health Organization. Retrieved fromhttp://www.who.int/healthinfo/EN_WHS2012_Part3.pdf