With just one midwife for every 5,000 mothers, Uganda is far from achieving quality maternal health care.


“My name is Ruth Nabakka. I am 35 years old and I live with my husband, Lawrence, and our five children in Kakooge sub-county in Luwero District, Uganda.

I am a housewife. In 1998, I gave birth to a baby at home in the village, but the baby died after three days. I was convinced that my neighbours were behind that death, that they had bewitched me. I was so afraid that any other babies that I had would also die. It was not until I learnt from the Community Health Workers in the village about the risks of giving birth at home that I began to realise that my neighbours might have had nothing to do with the loss of my baby.

The community health workers trained by AMREF give us a lot of health information that we did not know before. I learnt that if I go for all my antenatal check-ups and give birth in hospital, the baby will most likely survive. I had all my five children at the hospital.

I also know now that it is very important for pregnant women to protect themselves from malaria because it can weaken them and put them at risk of losing the baby. Many people in our village used to fall ill from malaria, and many women had miscarriages. Because I now know why it was happening, I make sure to protect myself and my family with mosquito nets.

It’s not that we had never seen mosquito nets, but we were ignorant before. Some women would be given nets for free but they would then sell them, or use them as bed linen. We are wiser now and people use their nets. That is why fewer people are getting malaria. People also used to fear taking their children for immunisation, because we believed that it would make our children sick.  But when the benefits were explained to us, more parents now take their children for immunisation.

We have learnt so much. The community health workers have also taught us the importance of drinking boiled water, breast-feeding our babies, testing for HIV and having a latrine at home. My husband has cleared the bushes and stagnant water around our home and our compound is clean.

I am happy. Because we do not fall ill as often as we used to, we are able to use the money we used to in hospital on other things. It fills my heart with joy to see my family well.”

“I am called Rossete Nakamoga and I live in Kakooge sub-county in Luwero District Uganda.

I am a housewife. My husband and I have four children aged two, four, six and 10.
I have known about AMREF since I was young. I knew they had something good for us when they started the project to train community health workers in our area. We have learnt a lot about health and how to take care of ourselves.

We never used to practise family planning because we did not know about it. The community health workers taught us about spacing our children. I appreciate the information because I can now work to take care of children that I have.”

We received mosquito nets from AMREF, and these have helped a lot because women and children in my village used to get sick often. Our family used to spend a lot of money on treatment. Now our children rarely get malaria because we sleep under mosquito nets.

I gave birth to all of my children in the hospital. The community health workers encouraged pregnant women to attend antenatal care from three months of pregnancy until we were due for delivery. I realise that it is important to give birth in the hospital because midwives can intervene if there is a complication. Another advantage of giving birth in the hospital is that a baby can be prevented from getting HIV from the mother.”

“My name is Nanteza Safina and I am 29 years old. I am a farmer in Luwero.

My husband and I have four children, the youngest of whom is two years old. I gave birth to all of my children in the hospital. I did this because of the encouragement I get from the community health workers to go to hospital for antenatal care when I was pregnant. Giving birth in the hospital is a safe experience because the midwife knows what to do during the delivery and after the baby is born.

Attending health education sessions organised by the community health workers has changed my way of thinking. If my child gets sick, I will take the child to the hospital quickly instead of waiting to see if they will get better or trying to treat him myself. I can even buy my own mosquito nets if the ones I have get torn because I understand how important it is to protect my family and myself from mosquito bites.

When I was pregnant with my youngest child, I was told at the clinic that the baby was big. On the advice of a health worker, I knew it was wise to go to the hospital early. I delivered the baby by Caesarean section and I was so grateful because my baby boy and I survived.

From drama shows organised by AMREF in the village I learnt that pregnant women must save some money to use when it is time for delivery. The money would come in handy if I was referred to another hospital and for a mama kit.

From the knowledge I received from AMREF health education, I can advise other pregnant women to see a doctor quickly when they are sick and to eat well for their own benefit and for their babies. But some women take a while to understand so the community health workers should continue giving us health talks.”

My name is Miriam Namusoke. I live in Wankanya Village in Luwero, Central Uganda.

I have been a Traditional Birth Attendant for a long time, but I never paid attention to the cleanliness of the environment where expectant mothers delivered. I did not know about mother-to- child transmission of HIV.

After the babies were born, I usually left them lying in the blood for a long time as I attended to the mothers. I had a delivery bed, but I preferred to use an old mat to avoid making the bed dirty. I hardly referred any woman to the health centre because I needed the money. Instead, I would try my best to make every delivery a success.

Once I lost a twin because I did not refer the mother to a hospital. The loss of this child wounded my heart and nearly ruined my reputation. In 2006, AMREF trained me on health, sanitation and maternal illnesses. They gave me a tool kit with all the equipment that a birth attendant needs in order to make her work effective. Can you imagine they even gave me a foetalscope! I was taught how to keep my home clean.

I learnt the risk of contracting HIV through my practice and worst of all the risk of exposing a baby to contracting HIV from the mother. I learnt that it was important to encourage mothers to go for antenatal care, and I now know which expectant mothers to refer to the health centre. No mother or baby has died in my village during delivery ever since I went for the training."

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