Rornald Kananura | October 2015
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Presentation at the Global Maternal Newborn Health Conference, October 19, 2015

Background: In addressing maternal and newborn mortality, a lot of initiatives have been put in place to encourage women access quality health services from the health facilities. However, this has not significantly changed for decades, thus a need to understand key maternal challenges that need urgent attention.

Methodology: This quasi-experimental study is being implemented in three districts of Eastern Uganda. The demand side involves, community sensitization, women saving for maternal and newborn services, whereas the supply side involves mainly health workers’ (HWs) capacity building. The study has no control over the provision of equipment/drugs and staffing.

Results: The results are based on the routine information collected by the VHTs from January-December 2014 and newborn death audits at both community and facility level. We indicate facility challenges contributing to the newborn death regardless of increased facility deliveries. Early results indicate an increase in facility deliveries from 65% to 78%. However, a considerate number of newborn deaths have been reported. A percentage increase in facility delivery indicated an increase in newborn deaths by 15 (P=0.026, 95%CI= 2.79-27.22). Additionally, a percentage increase in low-birth weights indicated an increase in newborn deaths by 7 (P=0.0191, 95%CI=1.416412-12.63334). The interviews with women and HWs indicated a number of challenges related to newborn death which included; lack of essential equipment, drugs and qualified staff. In addition, there is lack of space which leads to the discharge of women within four hours after delivery. Additionally, facilities are not fenced, have no security personnel and lack electricity which discourage the HWs from attending to women during night hours.

Conclusion: Lack of skilled personnel, drugs/equipment, insecurity and space are known facility challenges that have continued to curtail quality service delivery for maternal and newborn care in developing countries and limited efforts have been put in place to eliminate such challenges.