Pay more attention to maternal health care

By Vision Reporter

Recently, The New Vision published an article titled “Nurses beat women.” Such behaviour has resulted in the degradation of nurses or midwives and the debasement of the nursing or midwifery profession.

By Ann Kobusingye

Recently, The New Vision published an article titled “Nurses beat women.” Such behaviour has resulted in the degradation of nurses or midwives and the debasement of the nursing or midwifery profession.

Although the article talked about nurses, it is the midwives or nurse-midwives (double trained) who attend to pregnant women. While it is true that there are many midwives who ill treat women, not all of them engage in this counter productive behaviour.

Women are not a homogeneous entity because their experiences differ with variations in socio-economic variables like social class, place of residence and employment status. We, therefore, cannot equate the rural woman to an urban one, a financially independent to a dependent one, a banker to a street vendor or one with a physical disability to an able bodied woman.

Service providers who ill treat women will more often treat better a well dressed woman, one who can purchase the required medical sundries or drugs in case of shortage and probably one who offers a tip to the service provider.

Midwives encounter challenges in a bid to meet the health needs of women. For example, the service provider: client ratio is inadequate, This implies that the client load is at times overwhelming yet the government staff recruitment does not provide quick solutions to this problem.

In addition, the available infrastructure and logistics are no longer enough to address a population of over 28 million. For example, by the time Mulago Hospital was built, it was meant to cater for a population of 4.8 million.
Inadequate structures and facilities yet with increasing clientele create frustration among service providers some of whom transfer their frustration to clients.

Nurses and midwives are trained to alleviate suffering and to promote health. Their training does not involve cruelty to women as some people are forced to conclude.

More than 500,000 mothers die each year globally, of whom 98% are from developing countries. The rate of mothers who die during pregnancy and child birth (maternal mortality) in Uganda is 505 per 100,000 live births. This means 6,000 pregnant women die per year in Uganda because of pregnancy-related causes. This translates to about 16 mothers’ deaths per day.

It would, therefore, be right to say nurses and Midwives who ill treat expectant women are deliberate contributors to maternal mortality in Uganda.

This is because mistreatment of women is among the factors that lead pregnant women into the hands of untrained traditional birth attendants or unskilled relatives, especially for women in the rural areas.

According to Ministry of Health statistics, currently only 42% of mothers deliver from health units.
In April 2008 the ministry’s reproductive health division informed the public that the Government was discouraging the training of traditional birth attendants because they had failed to contribute to reduction in maternal mortality.

There is tendency to think women and infants only die under the care of unskilled people. We seldom think about those who die as a result of negligence or mistreatment by midwives.

Finance minister Ezra Suruma in this year’s budget speech observed that the health system in Uganda has continued to suffer from poor service delivery and inefficiency.

He said inspection under the health sector is necessary to regulate and monitor adequacy of the health system in delivery of expected outcomes.

Special attention, therefore, should be given to maternal services since maternal mortality is among the significant determinants of a nation’s state of health.

The writer is a registered
comprehensive nurse

Pay more attention to maternal health care