Written by Diana Nabiruma
Thanks to partnering groups in health, the ministry of Health is registering marked improvements in key areas such as maternal health.

In fact at a recent function, a ministry of Health official said one Ugandan district had not reported a single case of a mother dying during childbirth, a scenario probably unprecedented in a country and continent still grappling with high rates of child and maternal mortality. Dr Jacinto Amandua, the ministry of Health Commissioner for Clinical Services, said: “We didn’t have a single maternal death in Fort Portal in the last one year.”

He said this as he launched Management of Sciences for Health (MSH)’s strategic roadmap for Uganda on March 7 at the Serena conference centre. The international organisation works to save lives and improve the health of the world’s poorest and most vulnerable people, by partnering with health ministries to improve reproductive health, HIV, TB, malaria treatment, and drug distribution.

Stephen Lwanga, the MSH country representative, said because they will be able to “decide with government” on which programmes to engage in, they will have a bigger impact. Currently, MSH is running programmes like Track TB which aims at strengthening tuberculosis management within Kampala and its environs.

“Urban TB is a whole different matter,” said Lwanga, explaining why there is need to strengthen TB management in Kampala.

The Sunrise project is aimed at ensuring that consumers have access to drugs. The programme, Strides, for family health, is aimed at improving reproductive and family health. Amandua said efforts of MSH Uganda and those of others supplementing government efforts in health are paying off, as is the case with Fort Portal’s reproductive health.

He also said that working with MSH Uganda would enable government to learn and implement from MSH’s best practices.

Source: http://www.observer.ug/index.php?option=com_content&view=article&id=24277:uganda-registers-points-in-maternal-health&catid=58:health-living&Itemid=89

By BILL OKETCH

More than 30 expectant mothers seeking family planning and antenatal services at Anyeke Health Centre IV in Oyam District were on Monday left stranded as there were no nurses to attend to them.

Ms Rose Ogwang, who had travelled from Lira District, which is about 40 kilometers away, said the hospital had only two nurses attending to the many patients in the maternity ward. “Since I came here, I have seen only two nurses working in this maternity ward. At the moment, there are two mothers coming to deliver and yet they must also attend to us who have complicated cases,” Ms Ogwang said.

Ms Sarah Awidi, a nursing assistant, said most of her colleagues were promoted and could not remain at the facility. “This means poor quality services will be given to our mothers because you find the same nurse giving family planning services to the mothers is same nurse giving the treatment in the ward,” Ms Awidi added.

Dr Vincent Owiny, the district health officer, said the district lost a number of midwives in the recent countrywide recruitment because they were promoted.
Uganda, like many developing countries, is experiencing a human resources crisis in the health sector.

According to the 2010/11-2014/15 health sector strategic plan 111, the current number of health staff (Doctors, nurses, midwifes) in the country, totals to 59,000, with a ratio of 1: 1,818 people.

This is far below the recommended WHO minimum standard, which considers countries with less than 1 doctor, nurses or midwife per 439 people, in critical shortage of health workers.
Source: http://www.monitor.co.ug/News/National/Expectant-mothers-stranded-at-health-unit/-/688334/1724694/-/13gbd49z/-/index.html

By Moses Mulondo and John Odyek

The Government has rolled out a new intervention dubbed Option B+ to further cut down on mother to child HIV transmission by 90% in 2015.

The health minister, Dr. Christine Ondoa, announced the new intervention on Tuesday at the Media Centre during which she sounded a wake-up call to the country to rise up and fight HIV/AIDS. The prevalence rate has risen to 7.3% from 6.4% in 2005.

Flanked by director general of health services Dr. Jane Aceng, Ondoa noted with regret that with an average of 30% mother-to-child HIV/AIDS transmission, about 26,400 Uganda babies got infected with HIV/AIDS in 2011.

The Government started a robust Prevention of Mother-To-Child Transmission (PMTCT) in 2012 using AZT prophylaxis, which is referred to as Option A.

Whereas Option A only provides anti-retroviral therapy only during pregnancy, Option B+ promotes continuous antiretroviral treatment for life for all positive women even after pregnancy.

“This means that of the estimated 264,000 expected infections among exposed babies, less than 2,000 should become infected with HIV.

In 2012, only 16,000 got infected. This means that in one year, the PMTCT programme averted 10,400 HIV infections among children,” Ondoa said.

The minister announced that free PMTCT services will be available in public hospitals and all health centre IVs, most health centre IIIs and 15% of health centre IIs.

Ondoa revealed that Uganda has received about sh6.6b from the US and another sh15.8b from the Swedish International Development Agency (SIDA) to boost the implementation of Option B+ programme to curb mother to child transmission of HIV.

The US government will also avail about sh40b each year for the next five years.

The Ministry of Health and the office of the First Lady will launch Option B+ on Friday at Itojo Hospital in Ntungamo.

The theme for the launch is: “Stand out, participate, be counted, have an HIV free baby.”

Ondoa urged Ugandans to go for HIV testing, all pregnant women to go for antenatal care early, post natal care for breastfeeding mothers and ensuring that all pregnant women deliver in a healthy facility.
Source: http://www.newvision.co.ug/news/640867-govt-intensifies-war-on-hiv-aids.html

By SOLOMON ARINAITWE & ANGELLA NALWANGA
When Goretti Kajumba, 33, checked into a maternity suite at Mulago Hospital on December 3, 2012, she was full of optimism and joy, awaiting the birth of her first born.

However, the joy would soon be eroded by agony and frustration as her baby girl mysteriously went missing, minutes after birth.
The hospital insists the baby was born in “distress” and died soon after birth.

Ms Kajumba, on her part, says the baby was doing well and could have been sold by unscrupulous health workers. Her case becomes more baffling when she reveals that she was not shown the body of the baby, despite repeated requests to hospital staff.

“They [doctors] told me that the body was buried by KCCA but when I went to the mortuary, there was no such record. I have been asking doctors about my child but they kept on confusing me until I went to the director and told him that sir, you are a father, where is my baby?” a distressed Kajumba, weeping inconsolably, told journalists yesterday at Mulago hospital.

An Inpatient Discharge Form (IDF) signed by Dr Lubega shows that Ms Kajumba gave birth to a baby girl of 3kgs, with a rating of 9/10, on December 3, 2012 and was discharged on December 7, four days later.

However, Dr Baterena Byarugaba, the executive director Mulago hospital, who has been handling the case, says there “was a mix-up in documentation and that is why the baby was not recorded as dead” on the form.

“She underwent a Caesarian Section and gave birth at around midnight but the baby was taken to the special care unit and the mother to the High Dependence Unit because they both had breathing problems,” Dr Byarugaba explains.

He adds that the baby died in the SCU while the mother recuperated after a dose of intravenous fluids and blood injections.

Dr Byarugaba notes that the mother was admitted without a helper who could have assisted the hospital in indentifying the dead child.

After failing to make headway, the mother reported the case to Inspector General of Police Kale Kayihura, who in turn directed the Commander Kampala Metropolitan police Felix Kaweesi, to take up the matter.

Mr Kaweesi yesterday met the directors of the hospital and the latter agreed to co-operate in the investigations.
Source: http://www.monitor.co.ug/News/National/Mother–Mulago-in-dispute-over–missing–baby/-/688334/1725002/-/t5uw7r/-/index.html

By Patience Akumu,
When the woman entered Kiggundu’s office and requested an abortion, he felt his hands were tied: abortion is essentially illegal in Uganda. Kiggundu, a law-abiding citizen, told her that while he appreciated her predicament, he could only refer her for proper antenatal care so that she could deliver safely.

Three days later, he was called to the emergency gynaecology ward. And there, on the verge of death, was the same woman. “She was now a sick-looking, dirty young woman,” Kiggudu recalls. “Her intestines were out of her vagina and she was bleeding profusely.” The doctor asked the woman what happened.

“You are asking me what happened?” she answered. “I was here three days ago and you refused to help me; I did what I had to do.”

Kiggundu had to perform an operation to remove her uterus to save her life. She spent four weeks in the hospital recovering. Yet it could have been worse for Kiggundu’s patient. In 2008, the ministry of Health estimated that abortion-related causes accounted for 26% of all maternal mortalities in Uganda.

Uganda’s maternal mortality rate from abortion is 8% higher than that of East Africa which stands at 18%. The restrictive legal and ethical regime means that many women continue to die as a result of unsafe abortions both in and outside the hospital setting. The Constitution forbids abortion except as authorised by law, while the penal code criminalises abortion except where it is necessary to save the mother’s life.

Prof Ben Twinomugisha, a health law expert and lecturer at Makerere University, says that at the end of the day it is not really about statistics and legal provisions but, rather, about the woman who should be placed at the centre of the abortion debate.

“There is law and there is ethics. But what does the woman say?” he argues. “Whenever Kiggundu thinks of the woman without a uterus, he has regrets.”

According to Twinomugisha, the law is only restrictive and not prohibitive, and in fact he recognises that there can be lawful abortions. He points out that health workers are not utilising the law to provide abortions to women for whom having babies would mean adverse effects on their psychological and physical health. The 2006 National Policy Guidelines and Service Standards for Sexual and Reproductive Health and Rights provide for circumstances where a woman should be able to terminate her pregnancy.
Resource: http://allafrica.com/stories/201303110138.html