Kampala, Uganda | THE INDEPENDENT | The Kawempe Hospital obstetrics and gynecology department has not conducted maternal death audits over the last two years. Data picked from the district health information software shows that the department, housed under the National Referral Hospital, has the highest number of mothers and neonates dying annually.
It is estimated that more than 200 maternal and 2,000 perinatal deaths were recorded at Kawempe during the two years. However, no audits were carried out and as such, there is no explanation on what could have claimed the lives.
Dr Lawrence Kazibwe, the Deputy Executive Director of Kawempe Hospital attributes the gap to software glitches. He says that during the period under review, audits were undertaken but the information could not be uploaded on the District Health Information Software.
“We just got our rights as a health facility. Before, our data was confused with Mulago and ended up being deleted. We got rights in August to manage our data and we are in the process of uploading all our data,” Dr Kazibwe said.
It is mandatory for all government and private facilities to carry out maternal and perinatal death audits, in order to ascertain the causes of death among mothers and newborn babies. The 2016 Uganda Demographic and Health Survey established that maternal deaths stood at 336 deaths per 100,000 live births, implying that for every 1,000 births in Uganda, there are just over 3 maternal deaths.
Dr Livingstone Makanga the head of Maternal Health at the ministry of health says that every maternal death needs to reviewed and audited.
According to the annual sector performance report, 46 per cent of all cases of maternal deaths in the country were caused by haemorrhage followed by hypertensive disorders of pregnancy at 11 per cent.
Unknown or undetermined causes of death contributed to eight per cent of the deaths followed by sepsis during pregnancy with six per cent. Other cause included abortion complications, malaria, severe anaemia and anaesthetic complications.
Dr Sarah Zalwango, the acting manager medical services at Kampala Capital City Authority says that high death rates are being recorded in Kampala because it has the biggest health referrals.
According to KCCA, all hospital within Kampala are supposed to notify them of the death of a mother or infant immediately it happens. Audits are supposed to be carried out seven days after the death of a mother or child.
Clara Kukunda, a bio-statistician in charge of maternal-child health at KCCA says that field visits at health facilities have shown that some health centres do not bother reporting deaths or even handing in audits.
“They are supposed to inform us of every death and even carry out death audits but they do not. Sometimes the ones that carry out the audits never send them to us, so we never know whether an audit was carried out or not,” Kukunda said.
Rose Wakikona, a project coordinator at the Centre for Health Human Rights and Development-CEHURD says that most hospitals do not carry out audits because they think it is a waste of time.
According to the Annual Health Sector Review, 2018/19, only 51 per cent of all health facilities in the country carry out maternal death audits. Records indicate that Naguru General Hospital, Lubaga, St. Francis Nsambya and Mengo hospital are the only facilities that carried out audits of all deceased mothers and children.