Over the years, Rwenzori and Bunyoro region have been grappling with high neonatal and maternal mortality and are the highest contributors to the national under-five mortality rate.
To improve the care for small and sick newborns and reduce newborn death by 32% and 22% by March 2025 in mid-western Uganda, Uganda Newborn Programme (UNP) has been leading the way in improving survival rates and care quality across the mid-western Uganda.
Through the ELMA MNH project supporting the Ministry of Health’s efforts to reduce maternal and neonatal mortality, the programme has recorded tremendous gains following its latest data driven intervention in Bunyoro and Rwenzori Region.
Groundbreaking Achievements in Mortality Reduction
According to Dr. Rodgers Tugume, the Programme Coordinator for the ELMA MNH project at Baylor Foundation Uganda, institutional neonatal mortality in Bunyoro and Tooro has dramatically decreased. By the end of Year 2 of the project, mortality rates in these regions fell from 8.4/1000 and 11.9/1000 live births to 7/1000 and 2/1000, marking a 16.7% and 85.3% reduction, respectively. Cumulatively, the programme saved 15,790 newborn lives.
Dr. Rodgers Tugume, the Programme Coordinator for the ELMA MNH project at Baylor Foundation Uganda
Notably, the programme has also addressed the critical issue of birth asphyxia, reducing case fatality rates by 33% in both Bunyoro and Tooro, from a baseline of 9% to 6%. The maternal mortality rate has similarly improved, dropping from 123 and 77 deaths per 100,000 live births to 95 and 68, reflecting a 22.7% and 11.7% reduction, respectively.
Innovative Care Interventions at the Forefront
One of the key successes of the UNP has been its focus on improving the infrastructure and quality of care at Newborn Care Units (NCUs). With funding from ELMA Philanthropies, the programme refurbished two newborn care units at Buliisa General Hospital and Kyangwali HCIV, providing them with essential medical equipment like CPAP machines and oxygen concentrators. These interventions, coupled with targeted staff recruitment and training, have enhanced the capacity of health facilities to manage small and sick newborns effectively noted Dr. Tugume
‘’Through its mentorship programmes, the UNP has trained 166 health workers across 28 health facilities in the regions, significantly improving skills in emergency obstetric and newborn care (EmONC). This has resulted in a sharp increase in admissions of small and sick newborns, with a 55.4% increase in Bunyoro and 18.6% in Rwenzori, compared to baseline figures. The programme has reported an impressive survival rate of nearly 90% for these newborns, highlighting the success of its approach’’ Dr. Tugume added
Uganda Newborn Programme (UNP) Team, including Dr. Peter Waiswa (MD, MPH, PhD), Associate Professor at Makerere University School of Public Health (centre ); Darius Kajjo, Research Fellow at Makerere University School of Public Health (extreme right); and Beatrice Niyonshaba, Deputy Director of Maternal, Newborn, and Child Health Uganda at Adara Development(Left) in an engagement
Despite the successes, Dr Tugume acknowledged that the project has faced some challenges, including understaffing at NCUs and delays in the supply of essential medicines and equipment. These issues have occasionally hindered the timely delivery of care, and efforts are ongoing to advocate for better resource allocation and redistribution of medical personnel according to Dr Tugume
On lessons learnt, Dr Tugume cited the importance of community engagement in improving health outcomes as continuous dialogue with local communities has helped in raising awareness about the benefits of skilled delivery and neonatal care, contributing to a more health-conscious population.’’
On next step, Dr Tugume noted that the programme intends to expand the use of AIR/PRISMs technology to enhance newborn resuscitation skills at seven additional supported sites. Continue mentorship and support supervision to ensure that health workers maintain the skills needed to provide quality care as the project approaches its completion in March 2025’’ he added.
The UNP is a collaboration between key health organizations, including Baylor Foundation Uganda (BFU), Makerere University School of Public Health, Adara Uganda, and Nsambya Hospital, alongside the Ministry of Health. Together, these partners have worked tirelessly to implement a systems-strengthening approach with the aim of improving care for 120,000 small and sick newborns over three years and reduce newborn death by 40% at target hospitals