Uganda’s Maternal & Newborn Care Faces Critical Gaps Despite Increased Facility Births, New Analysis Reveals
KAMPALA, UGANDA - Despite a rise in births occurring at health facilities across Uganda, a new analysis of national survey data reveals important shortcomings in teh quality of maternal and newborn care, potentially undermining the gains made in access to delivery services. The study, published in BMC Health Services Research in November 2023, highlights critical gaps in essential interventions, supply chain functionality, and emergency obstetric care, raising concerns about the well-being of mothers and newborns nationwide.
The analysis, leveraging data from the 2022 Uganda Demographic and Health Survey (UDHS) and the 2023 Harmonized Health Facility Assessment (HHFA), underscores that simply delivering at a health facility does not guarantee effective care. While facility births have increased, the availability of crucial resources – like functional medical equipment, essential medicines, and skilled birth attendants consistently providing quality care – remains unevenly distributed and often inadequate, notably in rural areas and public facilities. This poses a ample risk to maternal and newborn health outcomes in a contry where, despite progress, maternal mortality remains a significant public health challenge.
Researchers found substantial variations in the provision of key maternal and newborn health services.The study points to deficiencies in antenatal care,including inconsistent screening for pre-eclampsia and gestational diabetes. Postnatal care also lags,with limited access to essential services like postpartum hemorrhage management and newborn resuscitation. These gaps are compounded by weaknesses in the health supply chain, impacting the consistent availability of vital commodities.
Specifically, the analysis draws on data indicating challenges in emergency obstetric care (EOC) access. A 2024 study published in Global health Science and Practice (Birabwa et al., 2024, pmid:39662976) detailed the complexities of care-seeking pathways in kampala, revealing barriers to accessing timely EOC even in an urban setting.This aligns with findings from the 2018 Service Availability and Readiness Assessment (SARA) conducted by the Uganda Ministry of Health, which identified systemic issues in the functionality of health facilities and the availability of essential supplies (Uganda Ministry of Health, 2018).
Further exacerbating the situation are documented issues within the health supply chain system. Studies by Lugada et al. (2022, pmid:35232485 & 36199111) highlight current issues, structural weaknesses, and performance deficits impacting the delivery of essential health commodities to facilities. These supply chain challenges directly affect the availability of life-saving medications and equipment needed for both routine and emergency maternal and newborn care.
The study emphasizes the need for a comprehensive approach to strengthening maternal and newborn health services in Uganda. This includes targeted investments in infrastructure,workforce development,supply chain management,and quality enhancement initiatives. Addressing these systemic challenges is crucial to translate increased facility births into tangible improvements in maternal and newborn survival and well-being, and to ensure equitable access to quality care for all Ugandan women and their newborns. The findings call for renewed focus on not just where births take place, but how care is delivered within those facilities.
