Makerere University School of Public Health is sowing seeds for communities to take greater responsibility for their welfare and that of their mothers and children using the Community Score Card project.
By Moses Tetui
WOMEN SHOULD NOT DIE IN LABOUR- My heart leaped on the news that I had finally become a father following a mostly exciting nine months for my wife and I. At that time, I didn't remember the morning sickness or runs I made to nurse my fussy eater. But that was really all that I knew about challenges of pregnancy. Living in the city and having private health insurance, inspired confidence to the extent that we never thought of tragedy as an outcome of pregnancy.
Almost a decade later, I am now frightened for expectant mothers I see in Uganda, where a daily average of 16 women die because of complications related to pregnancy and childbirth. What frightens me the most, though is not just the number of those dying, but how we have over time found ways to evade responsibility and make peace with death. This is wrong.
True the population has grown, and puts pressure on existing health facilities, but this is no excuse for our lack of planning and proportionate investment. It is, therefore, still wrong and every one ought to do something. Life is precious, and so it should be respected and treated.
Knowing that I still grieve for family that hurtfully left me, I just can't stomach how anyone with warm blood running through their veins can make peace with death, with what have become mantras like "we loved her, but God loved her the most," "it was her time," "there was nothing we could do," "she is in a better place."
It now more often than not sounds like complacency, the kind we now see across several aspects of our lives including education, security, nutrition and relations.
There is always something that can be done, and the Makerere University School of Public Health is sowing seeds for communities to take greater responsibility for their welfare and that of their mothers and children using the Community Score Card project.
A pilot in Kibuku district, eastern Uganda, seeks to work with several communities to improve maternal health. Our hope is that every mother and father should feel the true excitement of giving birth without being bombarded with nightmares of maternal deaths.
We are supporting communities, health workers, politicians and other leaders to score maternal health indicators of their choice on a quarterly basis. This scoring also involves holding accountable those responsible for improving the indicators, which is then followed by actions taken collectively to achieve the desired changes. With an implementation period that is just under a year, we have already started reaping benefits.
Some of the most visible achievements include, a successfully negotiation for more maternity ward space at the districts Health Centre IV, which is the highest level of care in this district by the way, they should have a district hospital by now. Also, communities as well as health workers are testifying of improved relations between them. By these engagements, we are collectively tackling the poor health worker attitude that is in our face every time we visit health facilities.
We are also receiving testimonies of increased male involvement in maternal health issues. And I could go on with lots of success stories resulting from this kind of social responsibility, but this is not the time or the place for this. I aimed to stimulate us to think and think again and then think again about what we are or not doing to avert unnecessary maternal deaths.
We need to return to being responsible for our actions and holding ourselves and others accountable. In fact, as a child, I enjoyed the parenting by an entire community and this instilled a great deal of responsibility in me. So, let us take our lives back in our hands and get back to action to create the change that we badly need.
The writer is a health systems researcher
Makerere University School of Public Health