STUDY TRIP TO MULAGO - UGANDAS NATIONAL REFERAL HOSPITAL.

Safe Motherhood A great Challenge to Musevenis Government.

We started our trip from Uganda Christian University (UCU) at 7:30 am Friday day
of February 2015. The university is located at Mukono District about 30 Kilometers
from Kampala, because of jam due to the thinness of the road and is a one lane and
thus we arrived at Mulago hospital at 9:45 am. At Mulago we visited Maternity ward
and Adolescent center, for today I will concentrate on Maternal Health at Mulago
Hospital.

Mulago is National Referral Hospital (NRH) for Uganda, commonly known as

Mulago Hospital,

it was founded in 1913 by Albert Ruskin Cook and in 1962 the

year that Uganda received its independence, hospital was inherited to Ugandas
government from the colonialists. Mulago hospital is located on Mulago Hill in the
northern part of the Kampala City, it is adjacent to Makerere University, it serves as
a national referral for the whole country and a general hospital as well as Health
centre IV, III for the Kampala Metropolitan. Official bed capacity is 1790, however
with that bed capacity the hospital serves more than 4000 patients and since the
capacity of the Hospital is limited to only 1790, thus one bed is accommodating two

mothers and their new born babies thus those who miss beds stay on the floor before
and after delivery.
APPLICATION OF PILLARS OF MATERNAL HEALTH CARE (SAFE
MOTHER HOOD) IN THE CONTEXT OF UGANDA AT MULAGO
NATIONAL REFERRAL HOSPITAL.
Safe motherhood is a vital, compelling and cost-effective economic and social
investment. Promoting womens health improves not only individual health but also
the health and survival of womens families, labour force and the wellbeing of
communities and families. Safe mother hood is a concept that no woman or foetus or
baby should die or be harmed by pregnancy or child birth.
Under the World Health Organization (WHO) there are four pillars of Maternal
Health Care (Pillars of Safe Motherhood) namely, Family Planning (FP), Antenatal
(PN), Postnatal (PA) and Emergence Obstetric Care. In the context of Uganda there
are six Pillars of Maternal Health Care/Pillars of Safe Motherhood as follows;
Family Planning, Antenatal Care, Postnatal Care, Emergence Obstetric Care, Clean
and safe delivery Services and Safe Abortion (SA).
Family Planning: We got information from the Nurse in charge of ward that family
planning is practiced but not to a great degree, we were shown a room where there
were women infected with HIV and did not realize that they are positive until the
time they went to the hospital. So, this indicated that family planning is not practiced
amongst women especially young women. More effort is to be put in making sure
that family planning becomes the hub of any woman in Uganda.
Antenatal Care: Is defined as planned programme of medical management of
pregnant women directed toward making pregnancy and labour a safe and satisfying
experience with an outcome of a healthy mother and baby. The hospital serves
almost all patients from the whole country, even if there are divisions of health
facilities namely level I, II, III etc still patient prefer to go to Mulago under the so
called Safe referral hence congestion at the hospital. After delivery depending on

the health of the mother and the baby, they stay at the hospital for a maximum of
three days then allowed to go home.
Clean and Safe delivery Services: Under this pillar, Mulago Hospital practitioners
and the administration are doing better, the hospital environmental is clean as well as
the labour wards. There are dustbin for keeping placentas from mothers who have
delivered, used gloves and other infectious materials. At Mulago a woman delivers
in assistance with a skilled attendant even though they are very few, the demand for
skilled attendant is very high. There is no alternative attendant in the case of
emergence. However, in some cases due to lack of facilities women may deliver on
the floor.
Postnatal Care: This refers to a care that is given to a mother and a baby after
childbirth up to 6-8 weeks (one and a half to two months). However, there are no
mechanisms for trucking the development of mother and the baby after being
released

from

the

hospital.

Emergence Obstetric Care: This is urgent medical care given to a woman for
complications related to pregnancy, labour, delivery and puerperium. It includes
basic emergence obstetric care example removal of placenta, Comprehensive
emergence obstetric care such as surgery, blood transfusion etc.

THE WAY FORWARD

In pursuit of a better service for all and as the slogan of Uganda states For God and
my Country, and instead the slogan now reads For God and my family. Its
important and crucial that the Government, Development Partners, Civil society
sector play a role in solving health problems in the country with a particular attention
to Safe Motherhood/Maternal Health Care. More efforts should be put to in
combating corruption and embezzlement of public monies by public leaders so that
more money is put into training more midwives, Procurement of equipments and
supplies. Ensuring that there is emergence obstetric care amongst pregnant women
by facilitating the presence of both Basic and Comprehensive emergence Obstetric
care.

CONTACTS:
In case of any query or more information contact me at;
dmziwanda@gmail.com
Dastan Mziwanda
Student MPHL Year1 (Save the Mothers).
Uganda Christian University.