Thumbs up to midwives serving in Karamoja

Several of them were deployed there is 2011 under the Midwives bonding agreement between the government of Uganda and the United Nations Population Program (UNFPA).

Many of them have been recruited by the government while others are still working as volunteers as they wait for their opportunity to enter the government payroll.

According to the Uganda Demographic and Health Survey 2011 (UDHS 2011), Karamoja was doing badly in the area of maternal care compared to other regions.

The survey results indicated that only 27.1 per cent women delivered at health facilities while only 30.9 per cent live births were delivered by skilled personnel.

The UDHS 2016 results show that there has been a big and steady increase in this area with 71 per cent mothers delivering at health facilities while 72 per cent live births were delivered by skilled personnel in the years preceding the survey. The statistics increased in both percentages and in numbers.

I was recently privileged to spend some quality time in Karamoja where I interacted with several stakeholders in the area of maternal health.

These included district health officers, mothers, men and opinion leaders. All of these were full of praises for these midwives who are credited for “bringing life to health centres in Karamoja”.

This is because the increase in the number of mothers delivering at health centres has automatically brought down the rate of maternal mortality in the Karamoja sub-region.

Before 2011, health facilities in Karamoja were very few and therefore distant, highly understaffed, poorly equipped and of course under-stocked. The few serving and over stretched nurses and midwives then were apparently not as nice as the bonded midwives now serving in the region.

To Karimojong men, health facilities were a no go area because traditionally, they saw no need for them to be present at a time when their wives were giving birth to their children. To them, it was a women’s affair.

In fact traditionally, Karimojong men attach more value to caring for the cows than their own wives and children.

A visit to health facilities like Nadunget HCIII, RUPA HCII, Lokitaleabu HCIII was a clear sign that the bonded midwives have indeed brought life at health centres in Karamoja.

More and more mothers now turn up for antenatal and postnatal care and the interesting part is that some of them are accompanied by their husbands. Previously, this was unheard of.
To me, convincing Karimojong men to abandon their ‘precious cows’ and accompany their wives to health facilities is a heroic act by the bonded midwives in Karamoja.

They have also demystified several myths and misconceptions surrounding pregnancy and child deliveries among Karimojong communities.

One of the misconceptions was that expectant mothers should not reveal labour in its early stages because this prolongs it.
The midwives have since convinced Karimojong mothers that this is wrong and with time, the mothers have proved them right. The huge increase in the number of health facility deliveries in the region is a clear testimony to this.

Adolescent girls are also slowly but surely turning up at health facilities seeking information and services especially regarding contraception. The midwives say offering youth friendly sexual and reproductive health services is part of their work and they hope to reach out to more girls using various strategies.

Encouraged by the impressive being done by these midwives, several agencies and organisations have intervened by providing equipment like ambulances, beds, mother kits, baby kits, essential drugs and payment of salaries to the midwives who have not yet been recruited by the government.

I came across babies who have been named after these midwives and their mothers say, this was one way of appreciating the midwives for saving their lives and the lives of these babies.
It is on this note that I am giving thumbs up to these young women– the bonded midwives.

Credit also goes to the ministry of Health and UNFPA for coming up with a bursary scheme that has seen these ladies enroll in midwifery schools and get bonded to the neediest health facilities for service after completing their studies.

Mr Weswala is the founder of The Community Agenda.