About 45,000 newborns die annually in Uganda, a new report has revealed. Over half of these die during the first week of life, particularly in their first 24 hours.
This means that four out of ten babies die before one year of age.
An equal number of babies are born dead.
This was contained in a situation analysis report of newborn health by the health ministry, with support from Save the Children, United Nations Childrenâ€™s Fund (UNICEF) and World Health Organisation.
The heartrending report, titled The situation analysis of newborn health in Uganda: Current status and opportunities to improve care and survival was presented by Dr. Jesca Nsungwa Sabiiti on Tuesday at Imperial Royale Hotel in Kampala
Why do the babies die?
About 82% of the deaths are caused by preventable infections and diseases. Doctors and midwives revealed that most babies are killed by infections (31%), some choke during birth (asphyxia (26%), others are born prematurely (25%), there are those born with defects (congenital - 7%) and others yet because of low birth weight (6%).
The study carried out household interviews where mothers mentioned long labour (35%), fever/infections (32%) and abnormalities at birth (13%) as the leading causes of their babiesâ€™ deaths. Among the infections, pneumonia was the highest at 31%.
Sabiiti regretted that the illness was caused by ignorance and too much anxiety. â€œSome mothers bathe the child immediately after birth, which exposes the child to the cold,â€ she said. â€œSome are worried about the umbilical cord. They want it to dry very fast and start putting all sorts of treatments like ghee, which may cause an infection.â€
Sabiiti also noted that others are reluctant to breastfeed exclusively, yet the prelacteal feeds and mixed feeding also cause diarrhoea.â€
According to Sabiiti, some women are reluctant to deliver at home.
This puts babies at risk should a complication occur. For example, while most babies breath spontaneously at birth, some require assistance to initiate breathing. This is hard to attain among women who deliver at home. â€œSome people try to shake the child. They think it is sleepy or lazy. In the process, it dies,â€ she said.
Mothers, who deliver at home, usually do not take their babies to be weighed yet baby weight is also associated with risk of death.
The 2006 Uganda Demographic Health Survey reported that mortality among children perceived small or very small was more than twice as high (45 per 1,000 live births as opposed to 21 per 1,000 live births of average or heavier babies at birth).
However, the biggest problem mothers in Uganda are facing is the inability to access adequate care or deliver under the skilled personnel. According to the report, 60% of pregnant women in Uganda give birth at home with limited access to skilled care. Four out of five newborns are not even seen by a skilled health provider during the first week of life.
Sabiiti lamented that some cultures secluded women during or after birth pregnancy. â€œThe woman is not allowed to go beyond the kitchen and all they use is ekyogero (herbs), yet the hygiene alone is poor,â€ Sabiiti said.
Hon Rosemary Seninde, the Wakiso woman legislator and chairperson of the Social Services Committee concurred, but added that even the few who accessed the centres did not receive adequate care.
She told her own story of the birth of her last born, now aged 14.
â€œI delivered at 5:00am and was asked to go to the corridors to give way for other women who was waiting. I put my lesu down and lay there. I developed fever and my baby developed a complication,â€ Seninde said.
Dr. Jessica Jiita of the ministry of health agreed: â€œLabour pains have this habit of starting at night! How does someone even get to hospital when they are far?â€
What can we do?
Up to two thirds of these deaths could be prevented if health services were improved to reach women and newborns.
The state minister for Health, Dr. Emmanuel Otaala, calls for the need to ensure ethics in health centres, saying some mothers are scared of going there because they fear that they will be treated harshly.
â€œAnybody who is found guilty of treating a patient harshly will be penalised,â€ Otaala says.
He also says districts need to enforce village health teams which should play the key role in sensitising the mothers in their homes. â€œAs Government, we shall continue providing facilities and skilled personnel. But we cannot go to help an individual who is not washing their hands after visiting the toilet,â€ minister Otaala says.
He, however, admits that there is currently no strategy of looking after the newborns during the first week of birth, which is highly risky.
â€œIt is true mothers are discharged immediately, because hospitals are overwhelmed. But we must find a way.â€
what should worry you
The mortality burden is way too high and trends have not changed much. Although women dying from childbirth decreased from 505 per 100,000 in 2001 to 435 per 100,000 in 2006 and children dying before their first birthday decreased from 156 per 1,000 in 2001 to 136 in 2006, experts are still concerned that causes of the deaths remain the same.
â€œThese are sobering realities. Some hard truths need to be heard. It is unacceptable to have preventable causes, doing so much harm,â€ says UNICEFâ€™s country representative Keith McKenzie.
â€œWe all want the people. But how will we do this, if we do not have facilities to ensure that the woman or the child â€“ the person of tomorrow - doesnâ€™t see even live to see the next day?â€ asks MP Seninde.
â€œThis shows that caring for women really matters. But how much longer do they have to wait?â€ asks Janet Jackson the representative of United Nations Population Fund.
Tips for new mothers
- As soon as you conceive, start antenatal care visits
- Make sure the visits are regular
- You have a right to ask for information regarding your pregnancy, child birth and if at all there is a complication, ask what you need to do.
- Deliver at a health facility
- Ensure that you exclusively breastfeed, proper hygiene and consult medical personnel in case of trouble
- Ensure cleanliness, during and after child birth to avoid infections like tetanus and diarrhoea.
- Donâ€™t expose the baby to the cold to avoid pneumonia.
â€˜45,000 babies die annuallyâ€™