Mukono General Hospital unveils modern neonatal unit

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Mukono General Hospital in Uganda's central district of Mukono has unveiled a modern Level II neonatal care unit to address the growing number of premature babies delivered at the facility.

Previously, the hospital had improvised by using the X-ray room since the hospital lacks an X-ray machine to provide neonatal care services.

“In the improvised unit, we faced challenges such as poor ventilation and high temperatures, but we had to start somewhere,” said Dr Geoffrey Kasirye, the hospital superintendent.

On average, the hospital would handle at least 200 premature babies every month.

“This facility delivers about 900 mothers every month, which translates to roughly 30 deliveries per day," said Kasirye.

"Due to a number of factors ranging from infections such as malaria, urinary tract infections and syphilis, to pregnancy complications like pre-eclampsia and premature rupture of membranes, as well as socio-economic challenges, we continue to receive many cases of premature births."

The hospital superintendent told New Vision the neonatal care unit — the first of its kind at Mukono General Hospital — was funded by Save the Children at a cost of sh185m.

After Save the Children conducted an assessment, the district administration and hospital board agreed to refurbish one of the hospital staff quarters into a modern neonatal care unit.

“Out of about 200 monthly admissions in the neonatal unit, we used to refer at least nine babies to Kiruddu National Referral Hospital [in Kampala] and lost about seven. Despite the limitations of the previous space, we have been serving a purpose and saving lives," said Kasirye.

The refurbished neonatal care unit at Mukono General Hospital. (Photo by Henry Nsubuga)

Dr Kenneth Kigoonya, the in-charge of maternal and child health at Mukono General Hospital, said Save the Children not only refurbished the facility to meet World Health Organisation (WHO) standards, but also equipped it with essential medical equipment.

The equipment includes baby cots, radiant warmers, phototherapy machines, pulse oximeters, Vayu bubble Continuous Positive Airway Pressure (CPAP) machines and accessories, incubators, glucometers, digital weighing scales, Vayu oxygen blenders and an oxygen manifold system to supply oxygen to the unit.

The organisation also trained and mentored health workers who will work in the unit, including doctors, nurses and midwives.

“They also donated newborn digital health tools such as PRISMS (Protecting Infants Remotely Through SMS), which allows health workers to monitor babies even in the absence of a specialist. They also provided the Augmented Infant Resuscitator (AIR), a simulator device that helps health workers practice ventilation skills, which are critical in newborn resuscitation,” said Kigoonya.

The new neonatal care unit has 15 beds, although Kigoonya noted that the high demand means some babies are already sharing beds.

“Even so, we are satisfied that the facility now meets recommended health standards."

'Serious concerns'

Dr Stephen Mulindwa, the Mukono district health officer, expressed concern over the shortage of essential medical staff at the hospital.

He said the hospital registered more than 117 newborn deaths in the past six months, partly due to the absence of specialists such as a paediatrician.

“I am not saying that if we had a pediatrician no baby would have died, but when babies die without a specialist around, it raises serious concerns."

Mulindwa pledged that once recruitment begins, hiring a paediatrician will be prioritised since the Ministry of Public Service has already approved the position and the wage structure.

The hospital’s staffing level currently stands at only 35 percent of the required workforce.

“That means every health worker is doing work meant for about three others. This affects our efficiency and leads to long waiting times for patients,” said Kasirye.

'Comprehensive overhaul'

Dr Mariam Ajiambo from the Ministry of Health’s Clinical Services Department, who represented the Director General of Health Services, commended the commissioning of the new unit.

She recalled visiting the previous improvised neonatal unit in 2014 and leaving heartbroken by the conditions.

“The ministry recognises that Mukono General Hospital is one of the busiest facilities in the central region despite its limited infrastructure. We are planning a comprehensive overhaul of this hospital so that it can better serve the community,” she said.

Ajiambo noted that while Uganda has made progress in reducing maternal mortality, neonatal mortality remains a challenge.

“At some point, we stagnated at 27 deaths per 1,000 live births for quite some time, but I am glad that the figure has now dropped to 22 per 1,000. However, according to the Sustainable Development Goals, we should reach 12 per 1,000 by 2030."



Speaking on behalf of Save the Children, Rachel Hopkins, Director of Programme Development and Quality, said the organisation believes every child deserves a healthy start in life.

“Together with government, communities and civil society, we ensure that children can realise their right to health, education and protection. A newborn’s first minutes of life are critical — warmth, oxygen, functional equipment, a prepared facility and a skilled health workforce can make the difference between life and death,” she said.

Hopkins said the refurbished neonatal care unit, which also houses an oxygen manufacturing system, will serve Mukono district and the surrounding areas given the fact that the hospital handles more than 10,000 deliveries annually.

'They gave me confidence'

One of the beneficiaries of the neonatal care services, Doreen Jemba Mukisa, said she delivered a seven-month premature baby and at one point, she almost lost hope due to the baby’s fragile condition.

“It was my first child, and I had no experience. I am grateful to the nurses, midwives and doctors who gave me confidence and cared for my baby. My daughter is alive today because of them,” Mukisa said.