Antenatal Care Keeps Ugandan Women and Their Babies Alive
At Kikyenkye Health Centre III near Ibanda, Uganda, I met 26-year-old Janipher Kyarimpa. We sat inside the maternity room, the walls lined with multiple posters about the benefits of antenatal care on one side and the significance of testing for HIV on another.
As she spoke, there was a sadness in her voice. I discovered that eight years previous, Kyarimpa had a miscarriage after she was given herbs by women known locally as “doctors”— traditional birth attendants.
One year ago, traditional birth attendants (TBAs) tried to make her deliver by having her drink two liters of cooking oil.
“Of course, the baby didn’t come out. Instead, I had diarrhea and became more sick. They didn’t understand that the body has its own contractions to push the baby out,” Kyarimpa explained.
Watching Kyarimpa now with her 1-year-old daughter, Kate, she holds her like she never wants to let her go.
Kyarimpa is expecting her sixth child. This is her fourth antenatal care (ANC) visit.
I had gone to Ibanda to document the success of the USAID-funded Regional Health Integration to Enhance Services in South West Uganda (RHITES). The program, implemented by the Elizabeth Glaser Pediatric Aids Foundation (EGPAF), through the Ministry of Health, is empowering women to seek antenatal care with the aim of ending maternal and neonatal deaths.
According to the Ministry of Health, in 2014, the maternal death rate stood at 356 mothers per 100,000 births.
Inside the maternity room, I sat on a chair, a respectful distance away from Kyarimpa and Agnes Tumuhairwe, the nurse in-charge of Kikyenkye HCIII maternity unit.
I ask why they think more women do not attend antenatal care.
Kyarimpa thinks for second, then says: “In the past, I wrongly feared that when I come to the facility, I would be forced to deliver by C-section.”
Tumuhairwe adds that some of the women also think that since they delivered their first and second babies successfully with the help of TBAs, there is no need to deliver the rest in the hospitals.
Yet failing to attend antenatal care and delivering outside the hospital can be very dangerous. When a traditional birth attendant helped Kyarimpa deliver, she almost bled to death, and an infection almost claimed the life of the baby.
USAID–RHITES, has brought a silver lining on the cloud. Women are organizing themselves into groups to learn more about the benefits of attending antenatal care and delivering in a hospital or other well-equipped health facility.
Women are no longer dying due to childbirth.
The program is also enhancing integrated health service delivery in southwestern Uganda. HIV services have been integrated with tuberculosis prevention, care and treatment; safe & voluntary male circumcision; maternal, neonatal care and child health; family planning; nutrition counselling; malaria treatment; and primary care services.
The aim of the program, implemented by EGPAF, is to increase the availability, accessibility, and quality of health services to deliver quality results and improved health outcomes.
The program comes with comprehensive health education both at the facility and at the weekly community outreaches, conducted by the facility’s health workers and Village Health Teams (VHTs).
The teams work with expectant mothers, young girls hoping to be mothers, and the community at-large about the benefits of attending ANC and importance of delivering at the facilities. Couples are also encouraged to jointly take an HIV test to protect themselves and their unborn babies against HIV.
“My husband and I both tested HIV-negative. This baby will be our last born, we have agreed to take family planning because it is hard to feed all the children and pay school fees,” Kyarimpa says to me as my visit comes to an end.
Kyarimpa is married to 30-year-old, Charles Asiimwe.
Asiimwe agrees: “We want to stay in good health to look after our children. Too many children are weighing down the health of my wife and also increasing the cost of treatment.”