KAMPALA: “No woman should die giving life!” This rallying cry echoed through the halls of the 4th National Safe Motherhood Conference held 29-31 October 2024, a poignant reminder of the unacceptable reality that still claims the lives of too many mothers in Uganda and globally. 

As stakeholders, policymakers and advocates gathered to address the persisting challenges in maternal and child health, one thing was clear: ensuring that every pregnancy is wanted and every child birth is safe requires urgent and collective action.

UNFPA joined the Ministry of Health and other key partners at the three-day event with the theme, “Strengthening Community Engagement for Sustainable Maternal and Child Health”, emphasizing the importance of community-led initiatives and partnerships.

In her opening address, Ms. Gift Malunga, UNFPA Uganda Country Representative, highlighted that  maternal and newborn mortality remain some of the most pressing challenges today and that this conference was an opportunity to seize the moment to renew joint commitments. 

“Today, we are united by one goal that no woman dies giving life. We can make this a reality by working together and leaving no one behind,” Ms. Malunga said. 

The maternal mortality ratio in Uganda has significantly declined from 336 deaths per 100,000 live births in 2016 to 189 deaths per 100,000 live births in 2022. Ms. Malunga commended this progress, highlighting that it exceeds national targets and demonstrates the collective efforts of the Government of Uganda and all stakeholders. Despite these gains, she added, many women still face daunting barriers to safe motherhood and preventable risks during pregnancy and childbirth.

“It is estimated that annually, 3,000 women still die due to pregnancy-related complications, and many more suffer from debilitating injuries and disabilities.”

In Uganda, postpartum hemorrhage remains the leading cause of maternal deaths, accounting for a devastating 38 per cent. Obstetric fistula continues to affect many women and girls, with an estimated 140,000-200,000 women and girls living with the condition and 1,900 new cases occurring annually.

Ms. Malunga emphasized that most of these deaths  are preventable with access to quality maternal healthcare services. This includes emergency obstetric care and the availability of skilled healthcare providers, particularly midwives, adequate health infrastructure and equipment. Additionally, by addressing social and cultural barriers to healthcare access, the majority of these deaths are preventable. 

“The elephant in the room is teenage pregnancy, which remains a significant obstacle to safe motherhood in Uganda and the linkage between teenage pregnancy and maternal mortality remains a great concern,” Ms. Gift concluded. “Alarmingly, teenage mothers account for a significant portion of maternal deaths in Uganda, contributing up to 18 percent of the 3,000 maternal deaths annually.”

According to the Uganda Demographic and Health Survey (UDHS, 2022), 24 per cent of girls aged 15-19 have begun childbearing, increasing the risk of maternal mortality, morbidity, and long-term health consequences, including obstetric fistula. 

Three key UNFPA-supported policy documents launched

During the conference, UNFPA Uganda launched three key policy documents to support safe motherhood programming by strengthening maternal health polices, improving access to quality health care and empowering women and girls to make informed choices. They were: The Health Facility Assessment for Reproductive Health Commodities and Services (2023); The National Annual Obstetric Fistula & Other Birth Injuries Status Report (2022/2023); and The Gap Analysis and Investment Cases Of Population-Related Indicators and Issues in Uganda (2024). 

Presentation of key insights and reports

UNFPA technical staff also played an active role in the Safe Motherhood Conference presenting insightful papers and reports that showcased the organization's expertise and commitment to improving maternal health outcomes. Ms. Julianna Lunguzi, Programme Coordinator (Integrated SRHR), moderated the opening session of the conference while Dr. Rchard Mwesigwa, Programme Analyst (Fistula), made presentations on the Annual Birth Injury Report, the Gap Analysis for Maternal health and the SDP survey report. Dr Timothy Kasule, Programme Analyst (Reproductive Health Commodity Security), presented a paper titled, “Business Case for Private Sector investment in Family Planning.”

The key takeaways from the Safe Motherhood Conference were as follows: 

• Teenage pregnancy is a major issue: Young mothers are more at risk of maternal complications and dropping out of school limits their potential and futures. Ending teenage pregnancy is a national issue that needs to be addressed. 
• Family planning and community engagement are crucial: While Uganda has seen a decline in the total fertility rate, it remains high. We need to scale up family planning services and address gender-based violence to improve maternal and child health.
• Sustainable financing is key: We need to invest in community health workers who are essential in bridging the gap between services and communities, especially in underserved areas and ensuring that women and young people have access to vital SRHR services.
• Addressing gender-based violence: Gender-based violence (GBV) has devastating impacts on maternal and child health. We must work tirelessly to create communities where women and girls feel safe and empowered to make their own choices about their bodies and their lives.
• We can make safe motherhood a reality for all women in Uganda if we all work together.

The conference concluded with a renewed commitment to collective action, ensuring that safe motherhood becomes a reality for all women in Uganda.

Written by Evelyn Matsamura Kiapi