With just five, Uganda moves to train more neonatologists to cut newborn deaths
The move comes amid a shortage of specialists trained to care for critically ill newborns, particularly premature babies and those born with breathing complications across the country.
Ministry of Health has embarked on a programme to train more neonatologists and neonatal nurses as part of efforts to reduce newborn deaths in Uganda. (Courtesy photo)
_________________
The Ministry of Health has embarked on a programme to train more neonatologists and neonatal nurses as part of efforts to reduce newborn deaths in Uganda.
The move comes amid a shortage of specialists trained to care for critically ill newborns, particularly premature babies and those born with breathing complications across the country.
Dr Richard Mugahi, the commissioner for reproductive and child health at the Ministry of Health, said Uganda has historically had only five trained neonatologists, despite the country recording between 1.7 million and two million births annually.
“We've only had five, and they were not trained in Uganda. The ones who deal with the very small newborns are called neonates. So, we've only had five and 50 million people are served by only five,” Mugahi said.
He said the government has started training neonatologists locally, with the first group graduating in June this year.
“Uganda would want to have a neonatologist in every region. Every regional referral should have that; that's our national target,” Mugahi said.
He said the government is also planning to train neonatal nurses, who are critical in providing specialised care to newborn babies.
According to the Uganda Demographic and Health Survey 2022, neonatal mortality declined from 27 deaths per 1,000 live births in 2016 to 22 deaths per 1,000 live births.
However, Mugahi said the country continues to lose newborns to preventable complications, particularly difficulties in breathing.
“Babies are still dying because of complications of breathing,” he said, adding that the planned neonatal care units would help facilities provide respiratory support to babies in distress.
This translates to thousands of babies requiring care every day, placing additional pressure on the country's limited pool of neonatal specialists.
Mugahi said premature babies who lack adequate surfactant in their lungs can develop severe breathing difficulties. Surfactant is a medicine used to help premature babies whose lungs have not developed enough to produce sufficient amounts naturally.
He said the medicine remains expensive for many families, costing about $200 (approximately sh750,000) per dose.
“We are going to advocate that the government make such medicines for preterm babies free so that they can be available even in the general hospitals,” Mugahi said.
The ministry also wants to increase access to Continuous Positive Airway Pressure (CPAP) machines and other equipment used to support newborns with breathing difficulties.
Dr Ruth Akello, the president of the Uganda Paediatric Association, said investing in neonatal specialists would have benefits beyond the specialists themselves because they would also train other health workers.
“Having trained the specialists, the specialists are able to train the lower-level health care workers to build capacity. And the result is worth the investment because we end up improving child health and reducing newborn mortality,” Akello said.
She said training specialists abroad had previously been expensive, with some of Uganda's first neonatologists trained in South Africa.
Meanwhile, Hanifa Kawooya, the State Minister of Health for General Duties, said the government was shifting greater attention towards newborns, who face some of the highest risks during the first weeks of life.
“Normally, the focus has been on those children who are below five years. But there are those ones who are born that very hour to 28 days old. And that is where most of the risks again are,” Kawooya said.
She said the government's position was that newborn deaths should not be accepted as inevitable.
“As a government, our emphasis is saying no baby is supposed to die. Every baby that is born has come out of the mom and must survive,” she said.
The ministry said expanding specialised newborn services, training more health workers and making essential medicines and equipment available at lower-level facilities will be critical to further reducing neonatal deaths in Uganda.