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Declining maternal mortality ratio in Uganda: Priority interventions to achieve the Millennium Development Goal
Author(s) -
Mbonye A.K.,
Mutabazi M.G.,
Asimwe J.B.,
Sentumbwe O.,
Kabarangira J.,
Nanda G.,
Orinda V.
Publication year - 2007
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2007.05.019
Subject(s) - medicine , millennium development goals , case fatality rate , staffing , psychological intervention , maternal health , maternal death , environmental health , health facility , developing country , standardized mortality ratio , mortality rate , medical emergency , population , nursing , economic growth , health services , surgery , economics
Purpose : We conducted a survey to determine availability of emergency obstetric care (EmOC) and to provide data for advocating for improved maternal and newborn health in Uganda. Methods : The survey, covering 54 districts and 553 health facilities, assessed availability of EmOC signal functions, documented maternal deaths and the related causes. Three levels of health facilities were covered. Findings : Few health units had running water; electricity or a functional operating theater. Yet having these items had a protective effect on maternal deaths as follows: theater (OR 0.56, P < 0.0001); electricity (OR 0.39, P < 0.0001); laboratory (OR 0.71, P < 0.0001) and staffing levels (midwives) OR 0.20, P < 0.0001. The availability of midwives had the highest protective effect on maternal deaths, reducing the case fatality rate by 80%. Further, most (97.2%) health facilities expected to offer basic EmOC, were not doing so. This is the likely explanation for the high health facility‐based maternal death rate of 671/100,000 live births in Uganda. Conclusion : Addressing health system issues, especially human resources, and increasingaccess to EmOC could reduce maternal mortality in Uganda and enable the country to achieve the Millennium Development Goal (MDG).