Maternal health challenges: Engage private sector

By Irene Mirembe

According to Uganda’s road map for accelerating the reduction of maternal and neonatal mortality and morbidity in Uganda 2006-2015, the current maternal mortality ratio of 435 deaths per 100,000 live births translates to about 5220 women dying every year due to pregnancy related causes.

Uganda being the 145th out of 180 countries with Maternal Mortality Rate with 16 women dying every day means we need to double our efforts.

Today, Uganda through partnerships efforts are implementing innovative and complementary private sector approaches at the community, facility and pharmacy levels in selected districts to address maternal health.

The partnership’s approach focus to increase informed demand for maternal health products and services, while simultaneously increasing the availability of high-quality products and accessible services and reinforcing critical linkages to higher-level referral facilities and services.

This approach is complementing the on-going government and donor efforts, increasing the total number of women with access to safe motherhood products and services.

 Such initiatives through the private sector ensure accessibility and availability of maternal services thus addressing maternal deaths through encouraging all the pregnant women to complete four visits of antenatal care as advised by the health provider, starting in the first trimester, and deliver in health facility and also have a birth plan.

Through use of community change agents like VHTs such private sector led initiatives are seeing expectant and new mothers receive a clean safe delivery kit at a subsidised price.

The kit comprises cotton wool, gauze, code ties, razor blade, child health card, two plastic sheets, soap and four pairs of gloves. Besides reducing infection, the kit is effective because the expectant mother gets many components at ago.

Nationally, the biggest contributors to maternal deaths are bleeding which accounts for 26%, infections at 22%, high blood pressure at 6% and obstructed labour at 13%.

Because the mama kit cannot address all the above, such as obstructed labour and high blood pressure, the service providers  in these clinics are continuously  trained   in basic and emergency and obstetric, such that they are skilled enough to know what they ought to do before referring the mother to another level. 

 It is a big win for the government for having enlisted the private sector actors in the provision of reproductive health services and programming.  This has led to effective progress and provision of reproductive health services to all women including low income ones.

Over the past three years, the significance of the private sector in complementing the work of the Ministry of Health has come to the fore. Take the example of all Ugandans who used modern family planning in 2011, 45% got it from the private sector.

 Engaging the private sector has led to Uganda making progress in reducing the maternal mortality ratio from 505 per 100,000 live births in 2005 to 438 in 2011.

Though this progress is commendable and the contribution of the private sector acknowledged, with continued effort we can celebrate if Uganda is to reach its target of reducing the maternal mortality ratio to the ministry’s goal of 131 by 2015.

To keep the private sector active, there is need for the Government and partners to continuously map private sector clinics across the country to ensure equity of coverage thus invest in upgrading the quality and range of services provided.

The beauty of engaging the private sector is that it offers economies of scale through increased demand arising out of subsidised client fees, marketing support to mention but a few. At the end of the day, the clinics serve more people in need at an affordable cost and turn out more profitable and sustainable.

With an estimated two million women seeking reproductive health services from the private sector, the 1000 or so clinics that are private owned is just a drop in the ocean. Increasing this number is critical, if Uganda is to revitalising the drive to reduce maternal mortality.

The writer works as Communications Manager at PACE