Monday, November 24, 2014

Public health facilities lack resuscitation devices, newborn deaths high- study

Publish Date: Nov 15, 2014  
Public health facilities lack resuscitation devices, newborn deaths high- study
The commissioner clinical services at the ministry of health, Dr Jacinto Amandua addressing participants during the meeting. PHOTO/Agnes Kyotalengerire

By Agnes Kyotalengerire                     

Majority of public health facilities are lacking basic equipment to resuscitate newly born babies leading to a high number of newborn deaths, a study has revealed.
The report also indicates that in the few health centers where there is equipment, medical workers do not know how to use them.

 “We lose babies who are born tired and cannot breathe because the health facility lacks equipment to resuscitate them,” said Barbara Zalwango a midwife working at Bulera health center III in Mityana district.

Resuscitation devices help to revive babies who fail to breath at birth a condition referred to as asphyxia.

The devices include: an ambu bag (neonatal bag) and mask, suction bulb and a training mannequin.

The study follows a survey that was conducted by White Ribbon Alliance Uganda in three pilot districts of Lira, Mityana and Kabale on the availability of newborn resuscitation devices has shown that most of public health center III and health center IVs lack equipment for resuscitating newborn babies.

Even where the equipment is available, health workers lack the skills to use it.

The national coordinator White Ribbon Alliance for Safe Motherhood Uganda, Robina Biteyi said none of the three districts met the minimum requirements for resuscitation of the newborns which leads to high number of newborn babies dying.

The study findings were revealed  during a stakeholders meeting organized by White Ribbon Alliance for Safe Motherhood Uganda on creating an enabling policy and  implementation framework for procurement , distribution  and availability of newborn resuscitation devices at Golf Course Hotel in Kampala  on Tuesday (yesterday).

 The district health officer Mityana, Dr. Fred Lwasampijja said the cases of newborn death in the district are alarming.

Dr Lwasampijja estimated that in a month about ten newborn babies die due to failure of midwives to resuscitate them when they are born distressed; tired and cannot breathe.

“These are few facility deaths but the number could slightly go up because some babies die at home and the cases are never reported to the health facility,” he said.

Dr. Victaria  Masembe working with WHO (left), the district health officer Mityana, Dr. Fred Lwasampijja(center) and the commissioner clinical services at the ministry of health, Dr Jacinto Amandua during the meeting at Golf Course hotel. PHOTO/ Agnes Kyotalengerire.

Bateyi said procurement of newborn resuscitation devices by ministry of health has been largely dependent on project by donors.

"Health centers cannot order for devices when they need them and mainly have to rely on the ministry of health to buy the devices when there is a funded project," she said 

 What the ministry of health says

The commissioner clinical services at the ministry of health, Dr Jacinto Amandua said with improvement in maternal and newborn health, focus is going to be put on acquisition of maternal and newborn equipment especially for resuscitation and also for helping mothers who have problems during delivery.

“The ministry is going to work with national medical stores to procure equipment for the public health units in addition to supplying medicines,” Amandua said.

He said procuring of resuscitation devices is only one aspect but it is important that every health facility has a skilled midwife to ensure the lives of mothers and newborns are safe.

Newborn mortality in health units is unacceptably high contributing to about 50% of deaths in children under the age of five years.

 According to the study, out of the nine health centers in Lira, only three had newborn resuscitation requirements.

In Mityana, out of 12 health facilities assessed, only 7 had the devices and in Kabale district 19 out of the 22 health centers had the devices.

This situation puts the lives of newborns at risk of death.

According to the Uganda Demographic health survey 2011, a total of 106 newborn babies die every day due to preventable causes.

Of these, 26% die on the first day of life due to failure to breathe and maintain breathing a condition referred to as asphyxia.

President of Uganda private midwives association, Mary Gorret Musoke said the ministry of health should plan with various stake holders to know how much is needed for each health facility, create a budget line for procurement of these devices and train the human resource to use the devices.

 Basic requirements for a labor suit

The president elect, association of gynecologists of Uganda, Dr Jolly Beyeza said a mother in labor should be attended to by two midwives; one extra to give a helping hand in case the baby comes out distressed.

Secondly, there should be a labor bed where a mother labors from, a delivery bed, a delivery kit with all the instruments required for conducting a delivery,  a resuscitation table with all the devices with a light up on the table to keep the baby  warm.

A partograph is also required to monitor the progress of labor, fetal heart.

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