Maternal and child health still a challenge in Karamoja

The Korean International Cooperation Agency (KOICA) and UNICEF on Wednesday handed over three ambulances to the districts of Amudat, Kotido and Napak to enable pregnant women access life-saving services or health facilities quickly.

The support which is part of the four-year UNICEF-KOICA partnership launched last year focuses on strengthening the continuum of care for maternal, new-born and child health services by addressing the three delays that are responsible for maternal and new-born deaths.

The continuum of care includes integrated service delivery for mothers and children from pregnancy to child birth, immediately after childbirth and through childhood.

The handover ceremony that took place at the UNICEF Moroto Zonal Offices in Moroto was presided over by the UNICEF's country representative Aida Girma.This was partly in celebration of the International Women's Day.

A nurse provides drugs to a mother at St. Pius Kidepo HC III in Moroto District.

 
Maternal and new-born mortality remain a global challenge and for Uganda, statistics continue to paint a grim picture with mothers and new-borns continuing to die from preventable causes.

The case of Karamoja as explained by the District Health Officer (DHO) of Napak, James Lemukol is a rather peculiar one characterized with very poor health indicators as compared to the rest of the country.

While the national maternal mortality ratio is 438 per 100,000 live births, that of Karamoja is estimated at 750 per 100,000 live births.

This, according to Lemokol is attributed to inadequate human resources at health facilities, limited access to health facilities, less equipped health facilities and social cultural barriers where most communities still believe in having children at home or with the help of traditional birth attendants.

A nutrition monitoring session in progress at St. Pius Kidepo HC III in Moroto District.

 
"Referral has been a very critical issue in this area with some communities as far as 20-30km from the referral hospital. It gets very challenging incase of an emergency," he explained.

Interventions such as these from partners have helped improve the situation, though a lot needs to be done.

"The ambulances provided today are timely and will address the second delay which occurs at the community level before reaching the health facility," said Aida Girma, UNICEF's Representative to Uganda.

The delays as Girma explained bar expectant mothers from accessing life-saving services in time.

Mothers listen to a health worker promote better and balanced nutrition for children and mothers at St. Pius Kidepo HC III in Moroto District.

 
The ambulance that was donated to Napak according to the DHO is to be based at Ateitolin health facility located at the district's border with Amuria. This is about 90km away from the referral hospital.

Ateitolin has an estimated population of about 25,000 people and accessing referral services has been very challenging. The ambulance therefore comes in handy for not just the village but the entire district. The district according to the DHO had one ambulance provided by the Ministry of Health but could not effectively serve all the areas.

A 2015 report on ‘Availability, utilisation and quality of maternal and neonatal health care services in Karamoja region' by Calistus Wilunda and others emphasises the challenges to maternal and child health care in this area highlighting the break-down of the formal health care system, the increased frequency of epidemics, the loss of adult family members to violent death, starvation, outward migration, the disruption of formal marriage structures and the increasing problem of alcohol abuse.
"In this region for example, coverage for skilled attendance at birth is only 31% compared to the national average of 58%." states the report.

A nurse consults with a mother at St. Pius Kidepo HC III in Moroto District

 
The four-year KOICA-UNICEF partnership, costed at $ 8,552,020 (approximately sh28 b) will target more than 100,000 expectant mothers, over 15,000 expectant mothers presenting with labour complications, and 100,000 children under five, including new-borns.

The project is being implemented in seven districts of the Karamoja region - Abim, Amudat, Kaabong, Kotido, Moroto, Napak and Nakapiripirit.  

A doctor at the Kanawat Health Centre III, in Panyangara Sub-County of northeastern Uganda, Kotido District, dispenses basic medicines to members of the community receiving outpatient treatment.

Woman waits to receive treatment at Loptuk Health Centre II in Nadunget Sub-county of Moroto District.

A Health worker gives child polio drops at a Health Centre in Kaabong District.