Maternal Health Blog Post

Danait Yemane, Jessica Namata, and Victoria Buckman

Maternal Health Blog Post

18 January 2015

Uganda has an astonishing maternal and infant mortality rate. This poignant fact is what ultimately sparked our group’s interest in maternal health. We chose to research this topic here because we wanted to further explore the status of maternal health from a public health perspective. We began our research by hypothesizing about the cause of such notable statistics, their impact on expecting mothers and their communities, and discussed possible solutions that could help better the status of maternal health. To find the answers to our questions, we met with medical professionals from both urban and rural locations, such as midwives from Kampala and Rakai District, traditional birth attendants, and OB/GYNs to learn about each of their unique perspectives regarding maternal health in Uganda. Our hope is that after synthesizing our findings from these interviews and site visits, this information will help us illustrate a clearer image of what maternal health is truly like in Uganda.  

            During our trip to Matale in the Rakai district, we were given a wonderful opportunity to spend five days with a home-stay family. In conjunction with our homestay, we were also given tours of the Rakai Health Sciences Program and the Kalisizo Hospital. At the hospital, we were able to interview a knowledgeable midwife who gave us information on the hospital, its medical professionals, and patients. We learned about the antenatal care process, which includes HIV testing, full body examination, and obtaining medications. Additionally, we learned about what happens during labor and delivery (high concentrations of c-sections), and post-natal care (follow up visits with the midwife as needed depending on the birth). After meeting with the midwife, we toured the facility and learned about some of the practices that take place in the labor rooms (collecting extra money for “higher quality” care) and observed the overwhelmingly crowded holding rooms and lack of sanitary equipment necessary for having safe deliveries.

Once we completed our tour, we learned about other individuals who assist pregnant mothers with giving birth: traditional birth attendants. These birth attendants use natural remedies and produce their own medications for patients to use for a variety of illnesses such as malaria, diarrhea, ulcers, etc. We were fascinated by the idea of a woman assisting mothers with the delivery of their child simply through natural methods so we decided to pay one a visit. With the help of Victoria’s host brother, Moses, we interviewed a birth attendant at her home and were given a tour of her herbal garden. She explained how she learned her techniques from other birth attendants and family members, showed us various types of herbs, which she uses to cure some of the illnesses mentioned above, and described how she assists between 10-12 mothers per week with giving birth with few tools and remedies. However, if the delivery has complications, she refers the patient to the hospital for professional help.

After our trip to Rakai, we returned to Kampala and visited Mulago Hospital.

Mulago hospital is the largest hospital in Uganda. It is a national referral hospital divided into two parts: Upper Mulago (old) and Lower Mulago (new). A midwife gave us a tour of the facility. First, she took us to the maternal care service reception where pregnant women are received, registered and then tested for HIV. In addition to this, the mothers are divided into counseling groups. All of this is done in a single shelter divided into compartments by desks. Depending on their HIV status, the mothers are then given private counseling from the doctors. Next, we went to the labor ward, which is composed of a single room divided into compartments by curtains for privacy purposes. After birth, the women are taken to the ward for recovery depending on the post delivery complications of the mother and baby. Next, the baby is tested for HIV: if the results are positive, the mother is advised to bring the child for another test. If the results are positive for this as well, and at 18 months, it is determined that the child has HIV. Once they have been confirmed as HIV positive, the child is connected to Bayler Uganda for medication and a follow up. At Mulago there is a follow up room where HIV positive women are registered for their health and medication free of charge.

Our group led a reflection session on January 17^th. During this discussion, everyone was given an opportunity to share their most memorable experiences (the good and bad) along with what they are looking forward to in our last week. A number of students were excited about the presentations and going to Jinja. Next, we played “Maternal Health Jeopardy” in our respective research groups and answered questions regarding ante-natal care, labor and delivery, post-natal care, traditional birth attendants, and miscellaneous topics from our trip so far. At the end of the reflection, we had a discussion on maternal health issues in Uganda and the US, such as abortion, contraception, prostitution, and natural medicine. Overall, the reflection session was very informative and all of the groups actively participated.

            Within the past two weeks, our group has gained a greater knowledge of the status of maternal health in Uganda. Through our home-stay, interviews with health professionals and traditional birth attendants, and detailed tours of health institutions, we believe that we are equipped to give an insightful presentation to our fellow peers and Makerere University staff. After our presentation and upon completion of this course, we expect to take the information that we have learned about maternal health in Uganda and apply it to certain aspects of American maternal health. We think that there are more similarities than differences between our two countries, as America still struggles with health disparities that impact expecting mothers of low-income families and other demographics. We look forward to sharing what we have learned about maternal health with our communities once we return home.