Since the onset of the COVID-19 pandemic in Uganda (March 2020), routine analysis of service delivery data by UNFPA showed an increase maternal deaths by 10.4%, from 1,089 in 2019 to 1,202 in 2020, according to the Health Management Information System (HMIS). In the 55 districts that are supported by UNFPA, maternal deaths increased by 41.1% in the period January-June 2020 compared to the same period January-June 2019. With the national lockdown entering into force in April 2020, most maternal deaths increments were registered across the first six months of 2020, which coincides with the onset of the COVID-19 crisis and related restrictions in Uganda as indicated in figure 1 below.

Figure 1: Maternal Deaths trends in Uganda, 2020

(Source HMIS, Jan-Dec 2020)

It is worth noting that in some districts like Kampala, maternal deaths almost doubled across the two years from 97 in 2019 to 185 in 2020 with majority (64%) of these being reported at Kawempe National Referral Hospital. Other districts with notable increases in maternal deaths include: Isingiro, Kaberamaido, Ngora, Katakwi, Kanungu, and Arua, all supported by UNFPA. UNFPA in conjunction with its partners including the Governments of Denmark, Netherlands, Sweden, Austria, United Kingdom worked to address the key barriers that were keeping women from receiving lifesaving maternal health care during COVID-19, such as delays in seeking and accessing care, compounded by movement restrictions, transportation challenges, poverty, among other COVID-19 related impacts. UNFPA supported districts with a package of life saving services for pregnant mothers, including emergency obstetrics care. These include among others:

· 4,255 women received delivery services.

· 1,088 women supported with Emergency Obstetric Care.

· 8,907 women received postnatal services.

· 54,517 personal protective gear (PPEs) provided for health workers and community resources. persons to continue provision of essential health services in the targeted districts.

· 579 Health workers supported with transport to health facilities.

 · 150,083,360 Uganda Shillings, worth of fuel provided to targeted districts to support ambulance and referral services.

 · 1 ambulance donated to districts to ensure that expecting mothers and health care workers could reach the health facilities despite restrictions on movements.

In addition, UNFPA supported routine maternal and perinatal death reviews in health facilities, and ensured that local leaders and communities participate in addressing the common causes of maternal and perinatal deaths, and are held accountable for health outcomes in their community. Additionally, UNFPA is part of the national task force on continuity of essential services which provides a platform for discussing key policy and programmatic issues pertaining to continuity of essential services.

 The impact

An analysis of data on maternal deaths in 55 UNFPA supported districts shows notable reduction in maternal deaths across the first period of the second half of 2020 (see Figure 1), which can be associated with the various UNFPA supported COVID-19 response activities implemented. Specifically, maternal deaths reduced in 24 of the 55 districts that are supported by UNFPA. It is worth noting that some districts for instance Moroto and Moyo registered zero maternal deaths in the last half of 2020, whereas maternal deaths in Arua, Adjumani, Kikuube, Isingiro, Koboko and Kampala districts reduced sharply (see Table 1 below).

Table 1: UNFPA districts with reduced maternal deaths-2020

Source :HMIS, Jan-Dec 2020

Mothers’ lives saved

Through the various maternal health interventions, an estimated 515,427 mothers were able to safely deliver in health facilities in the 55 UNFPA supported districts, including humanitarian districts in 2020.