Experts call women to seek antenatal care in first four months

The health ministry said it presently encouraged expectant mothers to attend eight antenatal visits so it can cut burden of 16 women who continue to die in pregnancy-related complications every day.

But it faced a dilemma of women who delayed to seek services until pregnancy was well in its seven month, onwards.

"Ideally, women should visit health facilities in the first trimester or before four months (for the first antenatal visit)," Dr Placid Mihayo, a gynaecologist and commissioner for sexual reproductive health at the ministry, said.

This way the expectant mothers can be able to complete all recommended eight visits, and give doctors enough room for examination and to make right calls in case of emergency.

When they start early,the mothers are also likely to receive important advice and counselling involving nutrition, sleeping under insecticide-treated mosquito nets, and consumption of prophylaxis fansidar to stop malaria, when they start early.

And, in case, they are HIV-positive, be started on ARVs to enable them live longer and healthier lives and also to prevent their unborn babies from contracting the virus.

Mihayo said this at the health ministry yesterday, during an engagement with health journalists.

He said , a number of women were uncomfortable disclosing their pregnancy until it was actually visible because of "social myths" but antenatal care also gave doctors chance to accurately estimate birth time.

Doctors will also have time to tell if the baby has no defects, he said.

More women die in pregnancy-related complications because they delay to seek care and to reach health facilities early.

The recent Uganda Health Demographic Survey shows that more women 97 percent receive antenatal care from a skilled provider, but a dismal 60 percent complete four visits, which was the old target.

Less than half of these return for postnatal care. They return at six weeks for immunization.

Dr Jesca Nsungwa Sabiiti, commissioner for community health at the ministry, said early this year the ministry tried to address the three delays, which contribute to maternal mortality.

That is the delay in decision making  the time women take bargaining whether or not to have their newborns delivered at heath centres.

Then the delay from home to health  facilities and the delay at the facility.

The ministry is using community health extension workers to spread importance of delivering at health facilities.

Then, through a USAID-funded programme, have introduced bicycle ambulances to transport expectant mothers to health facilities in selected 13 districts.

In other cases, the women are given transport vouchers at antenatal which they presented to taxi or cab drivers to take them to a health facility at labor.

Sabiiti said the ministry planned to refurbish health facilities, and to ensure each centre which offered maternity at least had a midwife and someone to perform anaesthesia (induced loss of awareness).

"At times we lose mothers at health facilities. But the real reason these mothers died was because they were brought when it was really late," Dr Henry Mwebesa, director general of health services, said.

He discouraged expectant mothers from going to traditional birth attendants.

Mihayo said the ministry had received sh200b which it will use to refurbish 331 health centre II's and convert them into Health Centre III's.

The ministry also intended to renovate an extra 40 HCII's and to upgrade them into HCIII's.

This will come in handy to eliminate more than 125 sub-counties or divisions across the country currently lacking any public health facility.

The meeting also addressed teenage pregnancies, estimated at 26 percent, and the unmet need for family planning also estimated at 28 percent.

Dr Mwebesa called men to stop engaging underage girls in sexual intercourse.

He said the ministry had received mobilized additional sh71b from development partners to procure family planning commodities.