Emergency obstetrics care brings smiles to rural Ugandan district

By MNH Admin February 11, 2019

 


At 27 years, Ms Teddy Babirye was in her fifth pregnancy out of which she was expecting her second baby, having lost three intrauterine. This pregnancy therefore meant a lot to her and she decided to attend her antenatal sessions at the Jinja Regional Referral Hospital, where she also expected to have her C-section done when due.

However, about two weeks prior to her operation while on a visit to her mother in Luuka, about fifty kilometres away from Jinja, things took a threatening twist for Teddy as she started draining her liquor without feeling labour pains.

“I got worried and I went to Kiyunga Health Centre maternity ward for assessment. The midwives assessed me, and my liquor had become green and my baby was getting tired,” Teddy recounts. “The doctor was called in and upon examining me, explained that I have to undergo an operation in order to save the baby. I consented, I really needed my baby alive, then the operation was done. I was very happy that it went on successful and I have my second live baby boy after nine years of waiting.”

Teddy is among the over two dozen women who have benefitted from the improving maternal and newborn healthcare services in Luuka District. It is not clear what would have happened to Teddy’s baby if emergency obstetric care was unavailable at Kiyunga Health Centre. The only next available options were Jinja and Iganga hospitals several kilometres away, where timely service could have been affected by delays along the way.

Functionalisation of emergency obstetric care services including the operationalisation of the theatre was made possible by the Community in which mothers and newborns thrive (COMONETH) project of Makerere University School of Public Health with support from the British charity Comic Relief.

The project aims at designing and implementing a community owned but facility-linked district-wide intervention that promotes high coverage with preventive care and improves quality of clinical care equitably leading to impact on maternal, perinatal and neonatal mortality in Luuka.

While COMONETH has just completed its first year, there are already interesting changes in the district especially at Kiyunga Health Centre IV which also serves as the referral facility in the district, and now having a fulltime doctor and an anaesthetic officer, thanks to the Project.

Since his recruitment and operationalisation of the theatre, Dr Felix Kizito (right) says many achievements have been registered among them the initiation of emergency obstetric services which has seen several mothers with life threatening conditions saved together with their babies.

“We have so far had 30 C-sections between mid-September 2018 when we started and as at the end of January 2019,” says Dr Kizito. “We provide support to the midwives on maternity ward on the daily basis to enhance quality care of the mothers. The newborn unit at the Health Centre has been functionalised and we are managing sick newborns as well. Dr Kizito adds that since January 2018 no single maternal death has been registered at Kiyunga.”

According to Dr Kizito, COMONETH is also involved in support supervision at all Health Centre III facilities, with an aim of improving services across the district.

A baseline study prior to COMONETH showed that rude health workers were affecting service delivery in the district. Mothers were preferring traditional birth attendants over midwives to deliver them with TBAs reported to be polite and trustworthy. 76% of the mothers delivering in health facilities were being aided by nursing assistants. Against a backdrop of 161 maternal and 12 newborn deaths were registered in 2017. Poor infrastructure, lack of running water in all but one health facility, low health sector (58%) staffing and absenteeism.

See COMONETH related blogs:

Verbal and Social Autopsies: Implications on the future of maternal and newborn health in Uganda’s Luuka District

Successes, challenges, and innovative solutions to improve maternal health in Luuka