September 27, 2011
END PREVENTABLE MATERNAL DEATHS IN UGANDA – A CALL FOR ACTION BY CIVIL SOCIETY
This is a day before the Uganda Constitutional Court proceeds with a landmark court case on maternal deaths – Petition Number 16 of 2011, in which Civil Society Organizations working in the health sector have petitioned the constitutional court to declare that the avoidable deaths of women in the process of childbirth constitutes abuse of their right to health. The petition further argues that by not providing essential medical commodities and health services to pregnant women, the government is violating the constitutional rights of Ugandans.
Pregnancy and childbirth should be a cause for celebration and fulfillment. However, on a daily basis, 16 women die in childbirth making their pregnancy experience a time for tears and mourning rather than joy and continuously perpetuating poverty and misery for families. The court case highlights the case of Sylvia Nalubowa of Mityana and Jennifer Anguko of Arua. The death of Mbale teacher Cecilia Namboozo is the current shadow of grief for us all. These now remain mere statistics.
Maternal mortality is just a symptom of a failed health care system. Issues that are pertinent to women’s health outcomes include access to family planning services, antenatal services, low girl-child education, motivated, skilled health-worker force and functional medical facilities have consistently been ignored. Lack of access to life-saving HIV treatment is another major contributor to maternal deaths — and results in high rates of mother-to-child transmission of HIV often leading to death.
Uganda’s Annual Health Sector Performance reports indicate that the percentage of supervised deliveries declined from 40% in 2008 to 33% in 2010. Additionally, only 45% of the health facilities in some parts of Uganda were providing emergency obstetric care in 2007 and there is no official government data from 2005 to date on this matter. The ever-increasing maternal mortality that we are witnessing today points to poor or lack of these services which unfortunately government is not aware of.
While Uganda has signed to many National, Regional and International commitments and guidelines on reduction of its high maternal and neonatal mortality and morbidity, improvements have not been forthcoming.
During the UN General Assembly held last week in New York, Uganda among many other member states, re-committed itself to implementing the Global Strategy for Women’s and Children’s Health Uganda spelt out the following areas of focus:
- Increasing comprehensive Emergency Obstetric and Newborn Care (EmONC) in hospitals from 70% to 100% and in health centers from 17% to 50%; ensure that basic EmONC services are available in all health centers; and will ensure that skilled providers are available in hard to reach/hard to serve areas.
- Reducing unmet need for family planning from current 40% to 20%
- Ensuring that Emergency obstetric and neonatal care services are available in all health centers
- Increasing focused antenatal care from 42% to 75% with special emphasis on Prevention of Mother-to Child Transmission (PMTCT) and treatment of HIV
However, we can only achieve the above targets by ensuring a well trained, motivated health workforce, working in a functioning health care system. Midwives and other priority health workers with midwifery skills are the answer. Uganda currently has a gap of more than 2,000 midwives.
As Civil Society we are calling for urgent action from government to stop the crisis of preventable maternal mortality. In particular, we call for a 2011/2012 supplementary budget that increases investments in life-saving emergency care, health workers, and medicines that could end Uganda’s crisis of preventable maternal death—an increased investment of approximately UGX 75 billion would fund the recruitment of 5,000 additional priority health workers including nurses, midwives and clinical officers and investments in their retention, particularly in rural health facilities.
We call on the Government of Uganda, political leaders, and policy makers to now move from commitment to action and commit to increasing its investments in order to deliver on these commitments given that the clock is fast ticking to 2015.
We demand for full accountability, every maternal death should be audited, followed-up and accounted for.