BUTALEJA– Busolwe General Hospital’s first-ever neonatal intensive care unit has saved up to 40 babies in less than one month, authorities have said.
The unit, which was launched in March this year, cares for premature babies as well as other babies born with health complications. The unit is designed to admit at least 10 premature babies at a time.
The hospital located in Butaleja district used the Results-Based Financing [RBF] funds to set up a neonatal unit and equip the maternity ward.
The RBF for Maternal and Newborn Health Initiative supports the district in addressing factors contributing to high numbers of maternal and newborn deaths using innovative approaches to health financing.
The introduction of RBF, a Ministry of Health project funded by the World Bank, provides small cash payments to women who deliver in an RBF facility and remain there during the critical period immediately after giving birth.
Medics at the hospital told this news website that the facility has helped reduce the infant mortality rate in the areas it serves.
Speaking during the RBF annual review meeting at Busolwe General Hospital on Monday, Dr David Okanya, the Busolwe Hospital Medical Superintendent, said they used RBF funds to set up the unit, which he said is working well.
“We used the same funds to train the midwife in neonatal care. The neonatal care unit is one of the biggest assets we have now. We are able to save the lives of babies from the time the hospital got it,” Okanya said.
“The unit which is only one month old has so far managed to save 40 babies with only one death. Because of the intervention of RBF, the maternal and newborn deaths have gone down,” he said.
Okanya added that they used the funds to connect running water in the hospital, connect security lights, purchase medicines and other health supplies.
“We have the capacity to bring more mothers from the lower health facilities and villages to hospital in a timely manner. The lower health facilities refer mothers and babies to hospitals using the RBF funds,” he said.
Busolwe hospital on aaverage, registers 187 normal deliveries with 62 caesarean deliveries monthly.
Dr Okanya further expressed concern over staffing at the hospital.
“As the district hospital we are supposed to have 21 enrolled midwives but we are having 16, 46 enrolled nurses but we have 28, 17 nursing officers but we are having three. We are supposed to have 11 doctors but we have five,” he said.
The facility serves mothers from Butaleja, Namutumba, Tororo, Budaka, and Bugiri districts that form part of eastern Uganda.
Initially, residents seeking the services of the neonatal units would be referred to Mbale Regional Referral Hospital, which is far away, making transport and medical expenses not pocket-friendly.
Ms Sarah Amusugutu, the In-charge Children’s ward in Busolwe Hospital, said before the RBF programme, the hospital used to have a number of challenges of maternal and prenatal death due to delayed referral of mothers.
“Before RBF we used to have a challenge of insecurity due to darkness in the hospital. Lack of neonatal intensive care services and poor hygiene due to water shortages. But all have been improved,” Amusugut said.
She said the RBF is currently promoting maternal quality.
“Compilated pregnancy-related cases are picked from lower health facilities by the RBF ambulance services of the hospital upon a phone call,” she said.
The programme’s goal was to enable more women, particularly from poor rural areas, to deliver in health facilities, and for those facilities to offer better quality maternal and neonatal care services.
Dr Richard Byamukama, a medical officer attached to Busolwe Hospital, said there was a significant reduction in maternal mortality during the programme period in the district since RBF was introduced.
“More women are delivering in health facilities than ever before and access to modern family planning continues to increase,” Dr Byamukama said.
Health workers are motivated by positive changes in their working environment, related to improvements in infrastructure, equipment, drugs and supplies.
He however said bad roads have led to delayed transportation of patients and frequent ambulance breakdown.
The Butaleja District Chairperson, Micheal Higenyi Bory, said the project has helped them to save pregnant mothers.
“It has helped us to save many newly born children and unborn children plus pregnant mothers. It has brought life to each and everything in terms of service delivery has improved in Busolwe hospital as compared to previous years before the project. Before the RDF the mothers were giving birth on the roadside and some mothers were being attended to by Traditional Birth Attendants [TBA],” Higenyi said.
Dr James Mwaka Agoba, the RBF coordinator in -charge of Busoga and Bukedi sub-regions, said they are supporting all the health centres in the district.
He said the project which started in 2020 has changed the health system in the district. “We have earmarked about Shs1 billion for the entire Butaleja in the financial year for RBF,” Dr Mwaka said.
Mwaka said the situation has improved greatly and staff is motivated to work at the 140-bed hospital commissioned in 1970.
Meanwhile, many poor women and their families struggle to find the money to pay for transport and other costs of delivering in a health facility
Statistics from the Health Ministry show that 38 per cent of the 39,000 deaths occurring in the babies’ first 28 days are due to premature situations. This is because premature babies’ lungs are underdeveloped, which causes breathing difficulties, among other health problems, experts say.
The infant mortality rate for Uganda in 2019 was 44.745 deaths per 1000 live births, a 3.02 percent decline from 2018. The infant mortality rate for Uganda in 2018 was 46.138 deaths per 1000 live births, a 5.27 per cent decline from 2017.
However, an estimated two of every 100 women still die from largely preventable maternal causes during their reproductive lifetimes, and maternal and newborn mortality remain among the highest in Sub-Saharan Africa.
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