Hundreds of newborns dying from 'preventable causes' in Lango

Lango, Uganda: While newborns, children, and mothers in other parts of the world benefit from lifesaving interventions, the situation in Lango Sub-region, northern Uganda, remains grim. Recent data reveals that 180 babies died in the Neonatal Intensive Care Unit (NICU) at Lira Regional Referral Hospital alone from January to December 2024.

At least 1,197 newborns were admitted to this government health facility, and 1,765 mothers were referred to the maternity unit due to complications, many of which have been attributed to what are described as "preventable causes."

Of the 6,425 deliveries conducted at Lira Regional Referral Hospital, 6,324 resulted in live births. However, 101 babies died during childbirth, according to official data released last week. Dr Andrew Odur, the acting director of the hospital, confirmed that 180 newborns died in the NICU.

Additionally, over the same period, 1,429 deaths occurred among the 31,322 patients admitted to the facility.

High blood pressure (hypertension) is the leading cause of morbidity in the region. Many individuals are unaware they have high blood pressure because it may not show obvious symptoms. Other health threats in the region include urinary tract infections (UTI), allergic conjunctivitis, common cold (without pneumonia), pelvic inflammatory disease, and sickle cell anemia. These conditions contribute significantly to the health burden in a region home to more than 2.7 million people.

Dr Juliet Adongo Ocol, a pediatrician at Lira Regional Referral Hospital and the regional coordinator for newborn health, emphasized that improving newborn survival rates is an urgent challenge in Uganda. "Perinatal deaths (babies who die before reaching one month) remain alarmingly high in the country, with a rate of 22%. This means that for every 100 deliveries, 22 babies die before reaching one month. The majority of these deaths are due to preventable causes," Dr Adongo stated in an interview on March 6, 2025.

She attributed these preventable causes to poor health-seeking behaviors among mothers, particularly during antenatal visits. Many mothers neglect important medications, such as folic acid, and fail to take necessary precautions, such as preventing malaria during pregnancy.

Dr Adongo explained that malaria, which is endemic in Lango, contributes significantly to morbidity among both mothers and newborns. "Mothers often do not take preventive measures, like using insecticide-treated mosquito nets or taking Fansidar during pregnancy. As a result, some mothers deliver prematurely—sometimes as early as five months—while others experience complications that lead to sick newborns," Dr Adongo said.

She also highlighted the role of teenage pregnancy and child marriage as contributing factors to the high rates of complications. "Many of the mothers with complications tend to be young. These children often don't carry the pregnancy to term, resulting in premature births that require extensive support, which can be costly," she explained. "This is a major concern, and we are advocating for improvements to reduce under-five mortality."

Teenage pregnancy and child marriage remain widespread across Uganda. From March 2023 to March 2024, a total of 2,476 girls under the age of 15 attended their first antenatal care (ANC) visit at various health facilities across the country. Data from the Uganda Health Information System revealed that an additional 1,755 girls in the same age group gave birth at health facilities throughout Uganda. In Lango, 52 cases were recorded among girls who were not of legal age for sexual activity but had conceived.

The data further shows that Oyam District had the highest number of cases in the Lango Sub-region, with 10 cases, followed by Apac and Amolatar, each with 8 cases. Lira City and Kole District each recorded 6 cases, Lira District had 4 cases, Kwania had 3, Otuke had 2, Alebtong had 2, and Dokolo had 3 cases.

Dr Carline Agaro, the Assistant District Health Officer (DHO) for Oyam, confirmed that from March 2023 to March 2024, 10 girls under the age of 15 visited health facilities for their first ANC visit. "5% of these girls were from Kamdini Sub-county, with three attending Zambia Health Centre II and two at Aber Hospital," Dr. Agaro said.

Oyam District includes 11 sub-counties and five town councils. Dr Agaro also revealed that Loro Sub-county registered two cases of girls under 15 attending their first ANC visit, while Acaba, Iceme, and Minakulu sub-counties each recorded one case. In total, 79 girls under 15 delivered at health facilities in Lango between March 2023 and March 2024. Amolatar recorded the highest number of deliveries, with 25 cases, followed by Oyam with 19, Alebtong with 15, Lira City with 10, Apac with 4, Kole with 3, Lira District with 2, and Dokolo with 1. Kwania and Otuke reported no cases.

Dr Agaro stressed the dangers of early sexual activity. "Morally and scientifically, young girls should not engage in sexual activity because their bodies are not ready for childbirth," she warned.

Official data from the Ministry of Health shows that 6,020 girls aged 15-19, whose bodies are not fully developed to carry a pregnancy, conceived. Additionally, 7,321 girls aged 20-24, who are typically in secondary school, attended health facilities for their first ANC visit.

Many girls and women continue to give birth at home, with some deliveries not captured in the national health system. According to data from the Uganda Health Information System, Lango Sub-region recorded 4,620 home deliveries between March 2023 and March 2024. Lira District recorded the highest number of home deliveries at 727, followed by Otuke with 708, Kwania with 630, Amolatar with 543, Alebtong with 533, Kole with 475, Oyam with 463, Dokolo with 250, Apac with 235, and Lira City with 56.

Between March 2023 and March 2024, 1,096 pregnancy-related deaths were reported by Village Health Teams (VHTs) in Lango. Lira District had the highest number of maternal deaths with 539 cases, followed by Kole with 348 cases. Other districts recorded fewer deaths, with Lira City reporting no maternal deaths.

Improved access to healthcare services, increased maternal education, and better malaria prevention could significantly reduce the number of maternal and neonatal deaths in Lango Sub-region. However, addressing challenges such as teenage pregnancy, inadequate health-seeking behaviors, and home deliveries remains crucial to improving health outcomes in the region.