Review mothers, newborns who die in private health facilities in Uganda

“You may have gone, but your exceptional legacy lives on through your family, communities and countless lives you touched”, I said.

Whereas pregnancy, childbirth and the period there after is expected to be joyful not only for the parents but also for the entire family, their relatives, friends and the community at large, it has turned out to be a nightmare for some whereby the mothers or newborns die during any of these periods.

Noting that March is a women’s month worldwide, this reminds me of different times where some female friends lost the battle (died) during pregnancy, others during childbirth, and also during the postnatal period. I have witnessed more others lose their babies either during pregnancy or child birth or even witnessed the babies die a few hours or days after delivery. Unfortunately, these deaths have all occurred in private health facilities in Uganda, including the high-end ones. To date, my heart still bleeds.

As a Nurse-midwife and women’s health specialist and advocate who participates and closely follows the review of deaths of such mothers and newborns, I have noticed that the focus of these reviews by the Ministry of Health Uganda is majorly for deaths that occur in public health facilities. In-fact, during such reviews, one may think there are no deaths of mothers or newborns in the private health facilities. But, is this true?

Yet, critically understanding exactly why a woman and/or her newborn died in pregnancy, around the time of childbirth or in the postnatal period is a crucial first step towards preventing other women and newborns dying in the same way.

So, the questions are “Who follows up on the women and newborns who die from these private health facilities?”. “How can the private health sector also be involved or empowered to participate in such reviews of the mothers and newborns who die during such periods moving forward?

One of the key interventions for improving maternal and newborn survival is understanding the number and causes of such deaths, as well as the systematic analyses of overall mortality trends including the events and contributing factors leading to such deaths. This helps to identify individual, community, institutional and health systems barriers generally and inspire local solutions to prevent such deaths in the future.

The Ministry of Health, Uganda conducts maternal and perinatal death surveillance and response (MPDSR) as a quality improvement tool that tracks and reviews deaths of mothers and newborns. This helps to improve the quality of care for mothers and newborns and prevent future deaths and taking action. The MPDSR helps to strengthen the quality of maternal and newborn programmes as well as routine data systems.

To the Ministry of Health Uganda, it’s imperative to acknowledge that reducing maternal and newborn mortality requires a collaborative effort. I thus strongly recommend fully involving the private health sector in the review of such maternal and newborn deaths during pregnancy, childbirth, and the postnatal period. In fact, I believe that such partnerships can facilitate the sharing of best practices, enhance data collection, and improve the overall quality of care. By embracing the culture of working together (the public health sector, private not-for-profit health sector and the purely private health sector), we can identify gaps in health service delivery, go ahead to develop targeted interventions, and ultimately reduce maternal and newborn mortality rates as a whole. Let’s unite to ensure that every mother and newborn receives the best possible care. 

Every mother deserves a safe delivery, and every baby a healthy start!

The writer; Lilian Nuwabaine Luyima is Worlds’ Best Nurse Finalist 2024; Multi-Award-Winning Researcher 2023; Heroes in Health Award Winning Midwife 2021 & Outstanding woman of 2021)