By David Serumaga
Mothers and newborns are the heart of the midwifery profession. With the right equipment and supplies, skilled midwives can save thousands of mothers and their newborns each year. Because they work in communities close to the mothers, midwives are uniquely positioned to provide the compassionate, respectful and culturally sensitive care a women needs during pregnancy and childbirth.
Midwifery is the practice of ensuring the safe and healthy delivery of the infant and placenta. A midwife tends to the general health and well-being of the mother during her preconception pregnancy and postpartum period. Midwives are the primary caregivers for millions of women and newborns before, during and after childbirth. Majority of Ugandan midwives have the standard minimum of nursing qualification, making them only capable of performing basic procedures.
Due to the effort of midwives, the health sector has recorded a reduction in mortality and fetal neonatal in Uganda.
A chat with Sister Zansanze Margret Serunjogi, a midwife in Kasana Health Centre IV reveals that for over 20years midwives have been in the lead to prevent Mother to Child transmission of HIV/AIDs. This is done through Sero Status Screening during routine Antenatal visits in a space of every three months. Negative mothers are encouraged to stay faithful as positive mothers are started on Anti Retro Therapy (ART) right away regardless of the CD4.
Sister Serunjongi says in her 30years of practice, she has been preparing women aged 15-35 from the period of preconception pregnancy to postnatal. She says the biggest challenge in her work has been husbands who do not support their pregnant wives. “Some of the women I receive lack care takers yet their husbands are out there in their leisure time, which makes our work tiresome. Despite this, we have been able to help such women because that is our profession. We are meant to save lives,” said Sister Serunjogi.
Midwives hold feeding sessions with mothers, which has minimized or eliminated death of children due to poor feeding. Sister Serunjogi said that they have gone ahead to train mothers on how to lay beds, keep their children in the mosquito nets which has reduced on the malaria rate in Uganda. They go a step further and monitor these mothers because some of them forget their lessons.
In order to reduce the Mother-to-Child Transmission of diseases like HIV/Aids that had risen in 1990s resulting from unprofessional Traditional Birth Attendants (TBAs), the Ministry of Health teamed TBAs with village health teams (VHT), to offer advice on basic healthcare to rural communities on topics that now include registering pregnant women, detecting danger signs among pregnant women and encouraging women to deliver in health centres.
In the past 25 years, the world has almost bisected maternal deaths. However, every year, some 300,000 women still die during pregnancy and childbirth globally, and almost 3 million babies do not survive their first four weeks of life.As Uganda embarks on implementing the Sustainable Development Goals, the role of midwives should be recognized and supported to ensure safe births.
Government has already prioritized the training of midwives to meet the country’s needs. In partnership with Government of Sweden there are bursaries for young people who choose midwifery as a career – with a special emphasis on hard-to-reach areas. These initiatives are critical in making midwifery a career of choice among young people.
The First Lady and Minister for Karamoja Affairs, Hon Janet Museveni in April 2016, commissioned 90 midwives hailing from Karamoja and Busoga and the districts of Yumbe, Oyam and Katakwi under the theme, “Zero tolerance to maternal and new born mortality.” In her address she said, “We should do our utmost best to prevent maternal and new born deaths.” The program is sponsored by Government and United Nations Population Fund (UNFPA) and it’s geared towards bridging the human resource gap in the area of midwifery and focuses on regions that have had very poor maternal health indicators.
Hon.EliodaTumwesigye the Minister of Health said in partnership with other development partners, a bursary fund has been established and a total of 462 midwives have been trained since 2010 and of that number, 160 hail from Karamoja region. 79% of these Midwives have qualified and are currently deployed.
Hon.Elioda also revealed that to further address the challenges midwives faces, government has formed Constituency Health Task Forces, as a formal structure to take charge of health facilities across the country. These Task Forces will be chaired by MPs and assisted by RDC’s and will be provided with 30 billion shillings each to repair health facilities, establish maternal facilities, screen diseases and support health educators.
Research around the world has shown that there cannot be safe motherhood without midwives whose work reduces complications in child birth up to 80%. Midwives also have a critical role to play in providing family planning and counseling.Midwifery is one of the professions that are less talked about and yet very key in the lives of mothers and their newborn babies. There are midwives who have exposed their lives to disease and other danger just to help a mother deliver a baby. And indeed some have died from diseases like HIV/AIDS which they contracted during their duty. Such and more in this category are the heroines we never hear about.
Today we celebrate midwives like Sister Zansanze Margret Serunjogi and applaud themfor the work they do in saving mothers’ and babies’ lives.