By Batenga Anita, Re!gnite Africa Youth Leader
The mothers of the nation are faced with all kinds of maternal and reproductive health difficulties. Rural expecting mothers having to walk miles to reach health centers for antenatal care and when facing labor pains. There are no enough medical personnel to help them at these health centers. Sometimes health personnel who are present are not qualified to carry out the complex medical operations required or are rude to those seeking care.
NTV Uganda reports that the long distanes and abscenteeism has partly contributed to reliance on traditional midwives who are readily available in the communities. In Karamoja for instance, it was reported that some women in a local sub-county opt to go to an elderly traditional midwife for antenatal care who sometimes is called upon by medical personnel to help out. In addition to this, the health centers have few beds, no reliable blood banks, no electricity, no running water and other necessities like blades & gloves. The expecting mother would have carried these necessities but she is impoverished and the little income she gets is to take care of her household relying on government to offer her free health services. Furthermore, when the operations become complex there is no ambulance to transfer the mother to the referral hospital. With this time lag and negligence the rural mother or her child dies. Just because of a selfish health personnel that pocketed the funds for hospital utilities and salaries of health workers.
But the health centers are not to be fully blamed because some mothers are ignorant about antenatal care; some are unaware of their HIV status, unaware of practices like sleeping under a treated mosquito net. They do not use family planning methods. Others are restricted by their cultural practices from attaining any medical treatment. Some rural families are marrying off girls that aren’t of age whose reproductive systems are not fully developed. All this worsens their health and creates complications at delivery.
Ministry of health and UNFPA have initiated trainings for midwives to equip them with skills to handle complex scenarios and on how to treat expectant mothers. They have also distributed life- saving supplies such as clean delivery kits (Mama Kits), they also support voluntary family planning services, comprehensive sexuality education and emergency obstetric care (though they should increase access to obstetric care like in California). The Pathfinder, an NGO in Uganda, has advocated for maternal and reproductive health. It connects communities and health care systems so that people can have access to quality contraceptive services. It also focuses on sexual and reproductive health needs of young people. The launch of the East African Community Open Health Initiative in 2013 advocates for improved reproductive, maternal, newborn and child health holds annual conferences for members countries to share solutions to common problems and to also identify strategies for improving health outcomes highlighting women’s and children’s health as a key area for investment.
A lot has been done but there is still more to do to protect the expectant mothers’ lives. Health systems must be strengthened, with quality facilities, personnel, equipment and medicine made accessible to all women. Comprehensive sexuality education and services for young people must also be made available. Supervised deliveries, improved antenatal services, and increased use of contraception like in Zambia where oral contraceptives are most commonly used, skilled medical attendance to mothers at birth and universal access to family planning should be ensured.
Other structural solutions changes are required. These include addressing poverty among women so that they have income to avail them access to better medical services and sensitizing women so that they make the right health decisions. Government can increase access to life saving technologies such as misoprostol and non-pneumatic Anti-shock Garment for postpartum hemorrhage to save lives of mothers especially those that give birth outside health facilities. Government should also improve existing health services by implementing simple low cost interventions like in Tanzania’s Kigoma Regional hospital. It should also avail ambulances at least at each health center IV.
The medical personnel should discourage voluntary demand for c- section unless it is an emergency because this procedure may involve risks like infections, hemorrhage and other complications. The medical personnel should also receive better pay to motivate them to do their job. As communities we can encourage expectant mothers to attend antenatal care, sensitize families on disadvantages of early marriages and also demand our political representatives to advocate for better health services as a right to the people.
The health of mothers is key to developing our nation because they are the backbone to any nation. Since they are mothers they are responsible for upbringing children.
Ugandans, let us rise up and advocate for quality access to not only maternal health but healthcare? At large! As it’s a right to everyone in the nation and a key aspect to attain development.