In regions like Bukedi only 7.8 percent of mothers get a chance to ultrasound scan services and in Busoga, it is estimated at only 7.6 percent. As a result, many women get into labour without being well prepared sometimes leading to prolonged labour and its resultant complications.
Only 31 percent of pregnant women across Uganda are doing
an ultrasound scan despite a policy by the Ministry of Health (MoH) to have mothers
assessed by the twenty-fifth week of pregnancy.
According to Dr Chris Ebong, a Senior Medical Officer
in the MOH, this policy that was approved in 2021 stipulates that all providers
of antenatal care services from the level of Health Center IIIs should conduct
a scan to determine gestational age, assess the state of fetus and be able to
rule out an abnormality or any likelihood of complications at an early stage.
However, he
says in areas like Bukedi only 7.8 percent of mothers get a chance to access such
services and in Busoga, it is estimated at only 7.6 percent. As a result,
many women get into labour without being well prepared sometimes leading to prolonged
labour and its resultant complications.
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The majority of the women doing ultrasound scans are in the
urban areas with Kampala leading in women who go for such services. Even then
he says, it’s mainly done by first-time mothers.
Currently, Uganda’s maternal mortality rate stands at
189 per 100,000 live births, an improvement of about 40% from 336 per 100,000 live
births about six years ago. Experts say Uganda may not achieve Sustainable
Development Goal 3 for which the country committed to cut their maternal
mortality rate to less than 70 per 100,000 live births by 2030 if the country
still cannot do simple interventions such as a scan just four years into this
target.
Dr Samuel Opio, the Deputy Chairperson
of the parliamentary Health Committee says on their recent oversight visit to
health facilities they found that in some government health facilities, there
are no radiographers to do the scan while in some radiographers take days
without reporting to work and as a result, many mothers are discouraged from
seeking the service.
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Opio further says that
this year, parliament approved an additional 113 billion shillings for the
National Medical Stores-NMS to cater for critical medical supplies which could help
in critical areas such as reproductive, maternal and newborn, child and
adolescent health but they are getting reports that health workers are instead
creating artificial shortages of such maternal health services.
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Dr Nicholas
Kamara, a member of the parliamentary committee says with the challenges of radiographers
and equipment shortage, the government needs to adopt
cheaper ways of bringing the service closer to the people. He cites a point-of-care ultrasound which midwives can use easily with simple training.
Kamara, who is a Member of Parliament Kabale Municipality reveals that he has already used this technique in a private hospital in his
constituency and it proved to be working as pregnant who are scanned can be referred
to higher facilities quickly once complications are detected.
Fatia Kiyange, the
Executive Director Center for Health, Human Rights and Development (CEHURD)
called for an extension of such services to the lowest health facilities like the
Health Center III because that is where most of the deliveries are happening.
She called for more
funding to go towards equipping such facilities as currently many cannot do a simple blood transfusion, yet postpartum haemorrhage is the highest killer of mothers
and is run by midwives.
Kiyange says that such facilities need to be responding to emergencies
and says things like point-of-care ultrasound scanning would come in handy.
