Posted Saturday,
August 4 2012 at 01:00
I would like to respond to the story titled, ‘Kabale
considers a by-law to force pregnant women into hospital’ in the Daily Monitor
of July 27. The story said the by-law will compel pregnant mothers to deliver
in a health facility and penalise those who deliver under the care of a
traditional birth attendants.
Experience from around the world suggests that about 15 per cent
of all pregnant women will develop obstetric complications and that not all
these complications can be predicted. Delivery under the care of a skilled
health care provider - midwife, doctor, or nurse with midwifery skills - is the
safest method for saving the lives of mothers and their newborn.
Countries with the highest skilled attended deliveries such as
Sweden and Malaysia are also the nations with the lowest maternal and newborn
deaths. Every year, 350,000 women worldwide die during pregnancy, or during
labour, almost 1,000 a day. Of these deaths, 99 per cent occur in developing
countries such as Uganda.
Every year, up to 2 million newborns die within the first 24
hours of life. Uganda looses 45,000 newborns annually; many more suffer birth trauma
that impairs their development and future productivity.
In recognition of the critical role of skilled care in reducing
maternal and newborn mortality and morbidity; Uganda has committed itself to
increasing skilled attended deliveries from 53 per cent to 90 per cent by 2015.
I would like to commend the local leadership in Kabale District
for recognising the importance of skilled healthcare and their intentions to
encourage mothers to deliver in a health facility instead of under a
traditional birth attendant. However, enforcing skilled attended delivery
through a by-law is not the answer.
A survey conducted by White Ribbon Alliance for Safe Motherhood
in six districts in Uganda (Assessment of Maternal Health Services in Six
Districts in Uganda, 2010) showed that health facilities in Kabale had only 2
per cent of the required midwives and only one doctor. None of the health
centre IVs could provide blood transfusion services or caesarian sections. Many
facilities lacked essential supplies, transport for referral of obstetric
emergencies at HC4 and 3.
I would like to request the decision makers in Kabale District
to examine the current healthcare delivery system and make it attractive to the
clients by providing an attractive healthcare delivery package to women. That
means adequate supplies, equipment, provision of emergency obstetric at HC 3
and 4, adequate midwives. Conduct community awareness raising about the
benefits of skilled attended births in addition to addressing social-cultural
factors that limit a woman’s ability to access her maternity care services.
The government should play its role of
ensuring adequate financial and human resources towards meeting its national
and international commitments on Millennium Development Goal 5 and support local
governments to deliver quality services to its citizens. Uganda committed
itself to giving the health sector 15 per cent of its annual budget.
Robina Biteyi,
Robina Biteyi,
National Coordinator
WRA Uganda
biteyi.robina@gmail.com
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