How Masindi is addressing maternal healthcare issues
fficials from Safe Path Mothers Foundation, together with Labongo Sub-county leaders and some mothers to whom they donated delivery items at Labongo Health Centre III in Labongo Sub-county, Masindi District, on March 8. PHOTO/ISMAIL BATEGEKA.
What you need to know:
- Local officials and health experts want the government and stakeholders to intervene and prioritise the reduction of neonatal mortality rates to improve the overall health outcomes of mothers in Masindi District.
- Despite incremental improvements in healthcare delivery, the district still faces significant hurdles, with maternal mortality rates soaring above the national average as Ismail Bategeka reports.
Marion Murungi lost her baby in November 2024 after enduring a complicated labour process at Nyakitibwa Health Centre III. This was after poor roads and lack of transportation prevented her from reaching the health facility in time.
“We had made preparations, but I was alone at home when the labour pains started. I was in labour for hours before I could find someone to take me to the hospital. I delivered the baby on the road, helped by well-wishers. However, the baby was already dead,” she recounts.
Similarly, Elizabeth Byalisiima lost her second-born child in September last year after she failed to raise the transport fair to Masindi General Hospital. Her labour pains began at 3am.
"By the time we hired a vehicle to take us to the hospital, it was 5am. The baby and I were both exhausted. It died at 8am. If my home was near a health facility, my baby would have been put on oxygen support. She would have survived,” she says.
Geoffrey Bagonza, the Masindi District health biostatistician, says in 2024, the delivery rates in the district's health facilities stood at 58.4 percent.
"We lack health facilities in Kigulya and Kijunjubwa sub-counties. In addition, the people of Kabango Town Council depend on private clinics because the nearest government health facility is in Kinyara Sub-county,” he says.
Masindi District has 51 government health facilities serving 10 sub-counties. However, only eight sub-counties have functioning health centres. Statistics indicate that maternal mortality stands at 500 per 100,000 live births, which is significantly higher than Uganda's national average of 435 per 100,000.
Dr Michael Mudu, the district health educator, says even where facilities exist, delivery beds and essential equipment are missing, forcing health workers to perform procedures in substandard conditions.
"The communities around our health centres are not generous. They use the water meant for the health facilities for their personal use, leaving our health workers to walk long distances in search of water to use after performing a delivery," he says.
Dr Mudu adds that the long distances to health centres also make it difficult for many expectant mothers to access them, increasing the risk of complications and preventable deaths. For instance, travelling from Kijunjubwa Sub-county to Masindi General Hospital costs Shs40,000 in public transport fare, which limits mothers from seeking antenatal services.
Penelope Kabasomi, the head of the maternity ward at Masindi General Hospital, says overcrowded and under-resourced health centres lack necessities such as water, power, and delivery beds.
“Power outages during deliveries are a serious threat to both mothers and infants, while inadequate supervision after delivery heightens the risk of postpartum complications, infections, and insufficient support for breastfeeding and newborn care,” she says.
Community rallies support
According to the 2022 Uganda Demographic Health Survey, cultural misconceptions and financial constraints discourage many women from seeking professional healthcare. Also, Masindi’s immigrant population, which accounts for 50 percent of the population, is less likely to use maternal health services, compounding the crisis.
Dr Mudu says community health workers and midwives are now identifying high-risk pregnancies and guiding women to health centres.
“However, the shortage of community health workers remains a pressing issue, and there is a need for more investment in this area and improved infrastructure to address the cultural barriers in maternal health. We need continuous community engagement and education,” he says.
Florence Mafiga, a member of the God is Good Women Savings Group, says groups such as hers in Kijunubwa Sub-county have become a lifeline. Women pool resources and help cover the transport costs of members to deliver at health facilities.
“We create emergency funds for transportation and medical expenses for our members and we have been encouraging other women groups to prioritise this aspect since it fosters community solidarity,” she says.
Maternity waiting home
One notable initiative is the construction of a maternity waiting home. The health facility, located in Kigulya Division, is a community initiative that allows expectant mothers to stay close as their delivery dates approach.
Milton Kutegeka, the chairperson of Kigulya Division, says the maternity waiting home will reduce the risks associated with last-minute travel and ensure timely access to skilled healthcare.
“Mobile health clinics conducted by the district health department on prenatal and postnatal services in remote areas, advocacy campaigns, and the distribution of maternal health kits further enhance rural mothers with maternal knowledge,” he explains.
Community-driven solutions and grassroots efforts offer hope, but systemic change is necessary to ensure no mother has to choose between her life and that of her baby due to inadequate healthcare. There is also a need to upgrade all health centre IIs to III to bring maternal services closer to the people.
