Death in the city: Can Kampala mothers, their newborns be saved?

When Kawuma’s wife went into labour in the wee hours of that night on a date which he doesn’t recall four years ago, his option was to rush her to the nearest government Health Centre IV which serves his Kisenyi slum in Kampala. However, the gate man told him there was no one to help her at that moment. The next stop was Mulago National Referral Hospital where a quack took advantage and lied to him to part with UGX 50,000 so he would get him a doctor. Kawuma waited for over an hour and neither the quack nor the promised doctor surfaced to help.

Kawuma was then advised by an onlooker to try a private facility (name withheld) where he was told the baby was tired and the mother had to undergo an emergency C-section. But he was told that that could only be done after he made a deposit of UGX 500,000 which he did not have. On reaching out to a friend, he advised him to try Mpigi Health Centre which is one hour away from Kampala. Although, Kawuma’s wife got that important operation, it was too late for the baby who they lost hardly two hours after delivery. This became another neonatal death in the statistics of Uganda.

Listening to Kawuma’s and such similar stories during the recent formative studies for Kampala Slum Maternal and Newborn (MaNe) project makes sense of the grim statistics that make Kampala one of the most dangerous cities for mothers and newborns. Based on the statistics we have derived from the government’s own health facility data, we estimated 200 maternal and 4000 perinatal deaths occur per year in Kampala health facilities with 64 percent of the latter being stillbirths or babies who die before they are born. The most affected are persons living in informal settlements with limited access to health care services. Surprisingly, ninety percent of these deaths are preventable with known interventions that are already policy in Uganda.

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