Following our analysis of health reports and policies as members of Young Leaders Think Tank for policy alternatives, we found out that the maternal section was quite alarming. Statistics shows that Uganda’s population growth is at 3.2% making it the highest in the world with fertility rate of 6.9 children for every woman in reproductive age. Out of 100,000 women who give birth every year 435 die which leads to about 6000 women dying annually due to pregnancy-related complications. The major causes of maternal mortality and morbidity in Uganda include severe bleeding, high blood pressure, unsafe abortions and obstructed labor. Majority of women in Uganda are subordinate to their male partners and thus lack decision-making powers as far as child bearing and family planning methods are concerned. Statistics also reveals that only 32% of women who give birth in Uganda receive care from trained personnel while the majority gives birth at home or under the supervision of traditional birth attendants.
The high prevalence of illegal abortions sometimes ends up in deaths and yet abortion in Uganda is illegal and is a sign of immorality in society. Health facilities especially in rural areas are not easily accessible due to the poor state of the roads. In addition, they face drug stock outs, have inadequate equipment and personnel, under skilled workers who are overworked, under paid and the situation is made worse by corruption. This state of affairs is also worsened by Poverty, culture, and limited education amongst the women which has hugely put the women in powerless positions hindering them from making decisions on how many children one can give birth to, negotiate for safer sex or even access quality services.
In the above light, different alternatives and policy proposals need to be explored in this country in order to strengthen the already existing efforts by different state and non state actors to improve the access to maternal health care services in Uganda.
Drawing lessons from other developing countries and projects which are very applicable to Ugandan context, there is need to strengthen access to more wholesome reproductive health care facilities that target mothers and their partners. This will ensure collective action and concern on issues of maternal health. Additionally, research should be geared towards alternative knowledge on maternal health such as traditional birth attendants to improve their services and in human capital development of community health workers such as the nurses, clinical officers and midwives, besides providing them with an attractive salary package. This in the end will ensure more inclusive policy formulation and as well help in integrating indigenous knowledge into internationally recognized practices. However this calls for a legal framework to regulate the work done by these Traditional Birth Attendants.
Means of monitoring and evaluating health programs should be devised in order to improve on access to maternal and reproductive health and as well checking on accountability and corruption by strengthening government’s capacity to monitor the effectiveness of programs. The fight to improve the status of women‘s health should not stop with the think tank, it needs to come to people’s homes, communities, and organizational boardrooms so that we all invest more resources in this area.
Young Leaders Think Tank for policy alternatives is an initiative of Konrad-Adenauer-Stiftung that brings together committed young Ugandans to interact and work in collaboration by analyzing policy issues and develop policy alternatives from the perspective of the young generation.
Written by Kaviri Ali
Youth activist and founding member Young Leaders Think Tank for Policy Alternatives Konrad-Adenauer-Stiftung