Understaffing cripples neonatal care unit at Mbarara hospital
The hospital officials reported that over 3,000 sick newborns are admitted to the NICU annually, with a third of these being born prematurely
MBARARA CITY, November 28, 2024 – Administrators at Mbarara Regional Referral Hospital (MRRH) have called on the Ministry of Health [MoH] to recruit additional nurses to care for the growing number of preterm babies in the hospital’s neonatal intensive care unit [NICU].
The hospital officials reported that over 3,000 sick newborns are admitted to the NICU annually, with a third of these being born prematurely. While the NICUs are equipped with advanced technology, trained healthcare professionals are essential to provide specialised care for these vulnerable infants. These premature infants are particularly prone to severe health complications, including respiratory distress syndrome, which makes it difficult for some to survive.
Speaking at the commemoration of World Prematurity Day on Friday, Dr. Elias Kumbakumba, Head of the Paediatrics and Child Health Department at MRRH, highlighted the severe lack of experienced nurses at the NICU.
Dr. Kumbakumba explained that MRRH currently has only seven nurses to care for 1,200 preterm babies each year. “Imagine one nurse managing 60 to 75 babies in a 12-hour shift. It is an intensive workload for our nurses,” he said. “We need a minimum of 30 nurses in the neonatal unit to ensure proper care for these premature babies.”
He further emphasised the challenge of inadequate nursing staff, stating, “Without well-trained nurses, we cannot do much in the neonatal intensive care unit.”
With the number of premature births on the rise in Uganda, Dr. Kumbakumba called for more support for both the babies and their mothers. “Uganda has about 1.6 million babies born each year, and up to 200,000 of these are preterm, requiring extra special care because they are so delicate. They can’t breathe on their own, they can’t generate heat, yet the world demands that they survive,” he said.
Dr. Stella Kyoyagala, Head of the Neonatal Intensive Care Unit at MRRH, noted that with the assistance of USAID, healthcare workers in peripheral facilities feeding into MRRH have been equipped with life-saving skills, in addition to strengthening the referral system.
However, she added that of the 1,200 preterm babies received at MRRH, only 900 survive, with 100 dying due to the insufficient number of nurses. “Preterm births contribute to 60 percent of all newborn deaths and 40 percent of all child deaths from birth to 15 years due to a shortage of nurses in this unit. This must be addressed,” Dr. Kyoyagala urged.
She also urged expectant mothers to adhere to the Ministry of Health’s guideline of attending at least eight antenatal visits throughout pregnancy to allow healthcare providers to identify potential conditions that could lead to premature births.
More responses
Dr. Francis Oriokot, Deputy Director of MRRH, acknowledged that staffing shortages are a concern across all hospital departments. “Currently, our staffing rate for essential staff is at just 11.6 percent, and our budget for medicines, sundries, and essential health supplies is Shs 37 billion, yet our current allocation is only Shs 2 billion,” Oriokot stated.
Margret Rwebyambu, the Woman Member of Parliament for Mbarara District, pledged to advocate in Parliament for increased funding to address the understaffing of neonatal units.
Dr. Deogratious Migadde, Senior Medical Officer at the Ministry of Health, highlighted that newborn mortality has reduced to 22 percent per 1,000 live births, despite ongoing human resource challenges. He also pointed out the lack of comprehensive data on newborns at the national level, urging hospital officials to share information with the MoH for better planning and budgeting.
“We need to recognise newborns as clients, and they should have their own medical files. This will provide us with the data necessary for proper planning,” Dr. Migadde said.
Dr. Richard Mugahi, Assistant Commissioner in charge of Reproductive and Infant Health, reaffirmed the Ministry of Health’s commitment to advocating for adequate staffing, equipment, and infrastructure development in the neonatal units.
Statistics from the Ministry of Health show that 38 percent of the 39,000 deaths that occur within the first 28 days of life are related to premature birth. Experts note that premature infants often suffer from underdeveloped lungs, leading to breathing difficulties and other health problems.
Testimonies
Irene Atuhaire expressed her gratitude to the medical staff at MRRH for saving her 26-week preterm baby, despite the challenges faced during the birth. “She was born at 26 weeks, and I spent 76 days at the NICU sleeping on the tiles. But I thank God, through the efforts of the referral neonatal doctors, my child is now healthy and growing,” Atuhaire said.
Betty Nuwagira also praised the efforts of the doctors and nurses at MRRH after her premature baby survived. “I was about seven months pregnant when I fell while mopping and started bleeding. I thought it was the end for my first baby, but thank God I gave birth prematurely. We spent three months at the hospital, and despite all the challenges, I am proud to see that my boy has completed his Primary Leaving Examinations this year,” Nuwagira said.
She encouraged mothers of preterm babies to seek medical support, reassuring them that their children can grow and thrive like any other child. Nuwagira also highlighted the lack of space at the neonatal unit, urging the government to improve health services in the country.
https://thecooperator.news/mbarara-hospital-boss-urges-govt-to-support-emergency-medicine/
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