The health ministry has asked all women of reproductive age to normalise taking iron/folic acid tablets at least once a week to avert the increasing cases of birth defects among newborn babies. 

The move, according to health experts, is also premised on the fact that many women in Uganda do not plan their pregnancies, while some do not attend antenatal care even after they discover they are pregnant. 

“Women of reproductive age should take iron or folic acid tablets at least once a week such that by the time they get pregnant, they have adequate nutrients that are sufficient for child growth,” Sarah Ngolombi, a senior nutritionist at the health ministry says. 

Ngolombi adds that apart from a few who plan their pregnancies, it is important for women to take a pill per week at least a year earlier.  

Folic acid is usually given to expectant mothers free of charge. However, it is also available in all government health facilities and the cost at private health facilities does not exceed sh1,000 per strip. 

In the absence of folic acid tablets, she advises that women should have a well-balanced diet, by varying their foods with basic proteins, energy-giving foods protective foods, among others.  

Ngolombi was speaking to journalists at the health ministry offices on Monday (October 24, 2022)  ahead of today’s commemoration of World Spina Bifida and Hydrocephalus Day. 

Spina bifida is a congenital condition that develops during pregnancy and is present at birth. The word spina bifida literally means “split spine”, as, during the first four weeks of pregnancy onwards, the neural tube and spine will not have developed correctly. 

Hydrocephalus on the other hand occurs when there is an imbalance between the amount of cerebral spinal fluid that is produced and the rate at which it is absorbed into the bloodstream. As the fluid builds up, it causes the ventricles to enlarge and the pressure inside the head to increase. 

Dr Isaac Ddamulira, a medical services supervisor at CURE Children Hospital of Uganda, said whereas the exact cause of Spina Bifida is not known, the insufficient intake of folic acid in the mother’s diet is a key factor in increasing the risk for spina bifida and other neural tube defects. 

“The effects of Spina Bifida, include leg deformities, lack or limited sense of feeling due to nerve damage that occurs, inconsistency of urine and stool due to nerve damage and hydrocephalus,” Ddamulira said. 

He explained that whereas surgery can be done within 48 hours of delivery the cost per surgery is sh6.2m with the exception of rehabilitation and follow-up. It is against this background that he reiterated the need for women to take folic acid tablets that are much cheaper.  

He recommended women eat foods rich in folic acid, such as spinach, beans, avocado, bananas, oranges, eggs, cabbage, beef and liver. 

Ruth Nalujja, the national co-ordinator of the Spina Bifida and Hydrocephalus Association of Uganda, said the association has so far registered a total of 12,000 people with spina bifida and hydrocephalus who are currently receiving treatment. 

Statistics from CARE also show that over 1,000 children are born with spina bifida annually.  

She, however, said the distribution of cases across the country is not even, adding that Kasese district currently has the highest number of children with spina bifida. She said this is attributed to the minimal services for children in the area.