Every year in Uganda, thousands of families face heartbreak during what should be a joyful moment childbirth. From stillbirths to babies who pass away shortly after birth, and others who survive with lifelong disabilities, the burden is heavy and often invisible in official reports.
But one researcher is helping to bring these hidden stories to light.
Dr. Phillip Wanduru, a rising leader in maternal and newborn health research has dedicated his work to understanding and addressing these challenges. Through a joint PhD program between Makerere University and Karolinska Institutet titled; “Intrapartum-related adverse perinatal outcomes; burden, consequences, and models of care from studies in Eastern Uganda, he has produced groundbreaking research focused on intrapartum-related adverse perinatal outcomes in Eastern Uganda helping us understand both the scale of the problem and what can be done to change the story.
Through his engagement with the Makerere University Centre of Excellence for Maternal and Newborn Child Health, he’s contributing to building evidence, influencing care models, and shaping policies that can improve survival and quality of life for Uganda’s most vulnerable newborns.
In this Issue, we hear directly from Dr. Phillip about his journey, his research, and the way forward for maternal and newborn health in Uganda and beyond.
Qn. First, congratulations on earning your PhD! What does this achievement mean to you personally and professionally?
On a personal level, I feel a deep sense of relief and fulfillment after earning a PhD in a field where I have spent years working and that I am truly passionate about. Professionally, I recognize how much I have grown and how my work is gaining recognition, and I am now preparing to make more contributions and become more involved in advancing maternal and newborn health.
Qn. Your PhD was a collaboration between Makerere University and the Department of Global Public Health at Karolinska Institutet. How did this partnership shape your research and perspective?
Integrating diverse perspectives in problem framing and solution development is essential for advancing and unifying global health research. I feel privileged to have been mentored by supervisors from both Ugandan and European institutions, each bringing unique approaches to problem-solving. Much of the learning comes from blending these different perspectives throughout the PhD journey.
On a broader scale, there is often a divide between “global” problems, typically shaped by wealthy countries, and local issues that deeply affect the poor. One key strength of the Karolinska-Makerere collaboration is the organic alliance formed between supervisors from Karolinska, Ugandan mentors, and the PhD student. Together, they shed light on often-neglected local problems through high-quality research and effective communication to the global health community. I now see this approach as a powerful way to bring local challenges onto the global agenda.
Pursuing a joint PhD also gave me firsthand experience in North-South collaboration, teaching me how to navigate and balance expectations from both contexts. Being accountable to both institutions has deepened my understanding of what makes partnerships successful, equitable, respectful, and accountable.
Qn. You’ve been closely involved with the Makerere University Centre of Excellence for Maternal and Newborn Child Health. How has the Centre supported your development as a researcher and advocate?
I have been part of the Centre for about eight years now. The founder, Professor Waiswa, has played a crucial role in my journey helping me secure a PhD position and serving as my supervisor. His support has been invaluable. Beyond his mentorship, the Centre is a lively community of brilliant minds dedicated to research that amplifies the voices of vulnerable women and babies. It’s an inspiring and motivating environment that encouraged me, especially as a young researcher when I first joined, to aim higher. I feel privileged to have had the opportunity to grow and develop within such a supportive space.
Qn. For those unfamiliar, could you explain why Intrapartum-Related Adverse Perinatal Outcomes are such a critical issue in Uganda?
Intrapartum-related adverse perinatal outcomes happen when babies face serious problems during labor and delivery. This includes stillbirths (when babies die before birth), newborn deaths within the first month of life, and brain injuries caused by difficulties during birth.
In my thesis study carried out at two hospitals in Eastern-Central Uganda, we looked at over 6,500 births between June and December 2022. We found that about 1 out of every 10 babies had one of these problems. Around 4% were stillborn, 0.6% died within 24 hours after birth, and nearly 6% had brain injuries linked to birth complications.
We also followed babies with brain injuries for a year. Those with mild injuries mostly survived well, but babies with moderate and severe injuries had lower survival rates, with about half not making it to 1 year, and others surviving but with disabilities.
The study found that emergency interventions, such as hospital referrals and C-sections, did not always effectively reduce brain injuries. This was mainly because they were not performed quickly enough to save the babies from injuries. Therefore, the timing and quality of care during birth are crucial. Delays in accessing proper care can result in these serious complications.
This shows that our health system needs to get better at responding quickly during labor and delivery. Many of these deaths and injuries can be prevented if care happens fast enough and is done well.
Qn. Your research went beyond just statistics; you included the voices of mothers. What stood out most from those powerful conversations?
In practice, obstetricians and midwives often focus mainly on the mother, while neonatologists, pediatricians, and neonatal nurses concentrate on the baby. However, the truth is that the mother and baby are inseparable. It is impossible to genuinely care for one without involving and caring for the other. Ignoring this connection can weaken the effectiveness of care. That’s why, even though my work is mainly about baby outcomes, I also make it a point to elevate the voices of mothers, especially those most vulnerable, to understand their experiences better and find ways to support them in caring for their babies.
Qn. One key finding from your study was that emergency referrals and caesarean sections didn’t significantly lower the risk of neonatal complications like encephalopathy, unless there was prolonged or obstructed labour. What gaps in our healthcare system does this highlight?
Referrals and emergency caesarean sections are vital for saving lives during complicated births. However, to truly protect babies from brain injury, known as neonatal encephalopathy, these interventions need to happen much faster. In my research, I found that while these actions probably helped keep many mothers and babies alive, they were often not quick enough to prevent brain injuries in newborns. Hospitals should focus on improving the speed and efficiency of these emergency responses to better protect babies.
Qn. Funding is often cited as a key challenge in maternal and newborn health. How does funding impact care delivery and research in this field?
Funding limitations affect every level of the healthcare system, from inadequate staffing and equipment shortages to insufficient training and weak data systems. Without consistent and adequate funding, even proven interventions cannot be scaled or sustained effectively. Moreover, research funding is often scarce, limiting our ability to explore innovative solutions or monitor progress. Advocating for increased investment in maternal and newborn health is critical to bridging these gaps and saving lives.
Qn. Based on your findings, what urgent actions should policymakers, health leaders, and communities take?
The key message is that many baby deaths are preventable. Pregnancies that are near or at full term should not end in death due to complications during labour solutions for these problems have existed for over a century. The first step is to accept that doing nothing is unacceptable. Then the important question is: what actions should be taken? I strongly recommend improving how current interventions are carried out to make them more effective. I am not calling for new treatments but for better use of what we already have. For example, an emergency cesarean section should not take five hours from the moment it’s decided to when it’s actually performed. This time can be shortened to save not only lives but also protect babies’ brains. The same urgency applies to referrals if it takes six hours for a mother to reach the hospital, that’s not really an emergency response. Additionally, securing adequate and sustained funding is paramount to support these changes and improve care quality.
Qn. Your work shows how parental involvement can improve newborn outcomes, yet in practice, this remains limited in many low-resource settings. How can we better empower parents in neonatal care?
As healthcare providers, our time with newborns is brief, with most caregiving involving parents. Therefore, it’s crucial to help parents feel confident and actively involved in their baby’s care. My research indicates that while parents do a lot, they are often not regarded as equal partners in their baby’s care, as our focus tends to be on delivering medically approved lifesaving procedures. Fostering a positive parent-baby relationship significantly benefits the baby’s healing, emotional growth, and even the mother’s mental health. True progress happens when we listen to parents and incorporate their ideas. Although there’s no quick solution, the best approach is for parents and healthcare professionals to communicate, listen, and collaborate.
Qn. For young people inspired by your work and interested in maternal and newborn health research, what advice would you give them?
Young people today have access to more resources, analytical tools, and social media than ever before the world is more open and connected. I encourage them to use these tools and opportunities to make a real impact. I tell them, don’t be afraid to step up and lead . you are more than capable, and your voice is needed. Babies, mothers, and many vulnerable people are counting on you, so have the confidence to make a difference.