Newborn survival in Uganda: a decade of change and future implications

Abstract

Each year in Uganda 141 000 children die before reaching their fifth birthday; 26% of these children die in their first month of life. In a setting of persistently high fertility rates, a crisis in human resources for health and a recent history of civil unrest, Uganda has prioritized Millennium Development Goals 4 and 5 for child and maternal survival. As part of a multi-country analysis we examined change for newborn survival over the past decade through mortality and health system coverage indicators as well as national and donor funding for health, and policy and programme change. Between 2000 and 2010 Uganda's neonatal mortality rate reduced by 2.2% per year, which is greater than the regional average rate of decline but slower than national reductions in maternal mortality and under-five mortality after the neonatal period. While existing population-based data are insufficient to measure national changes in coverage and quality of services, national attention for maternal and child health has been clear and authorized from the highest levels. Attention and policy change for newborn health is comparatively recent. This recognized gap has led to a specific focus on newborn health through a national Newborn Steering Committee, which has been given a mandate from the Ministry of Health to advise on newborn survival issues since 2006. This multi-disciplinary and inter-agency network of stakeholders has been able to preside over a number of important policy changes at the level of facility care, education and training, community-based service delivery through Village Health Teams and changes to essential drugs and commodities. The committee's comprehensive reach has enabled rapid policy change and increased attention to newborn survival in a relatively short space of time. Translating this favourable policy environment into district-level implementation and high quality services is now the priority.

Newborn Care Practices among Adolescent Mothers in Hoima District, Western Uganda

“…Applying substances on the cord exposes the newborns to infections like sepsis . Infections are one of the leading causes of neonatal mortality in Sub Saharan Africa [17] and in Uganda [32]. …”

Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

“…It has been recommended that countries need to strengthen health systems to control the spread of antimicrobial resistance. 6 Strengths and limitations of this study ▪ This study is based on a large cross-sectional survey of drug shops in Uganda. ▪ It aims at assessing practices of antibiotic prescription at drug shops, with a focus on the use of antibiotics for the treatment of respiratory tract infections, in order to inform future study designs of interventions to improve quality of care in this sector.…”

Is facility based neonatal care in low resource setting keeping pace? A glance at Uganda’s National Referral Hospital

“…With intensive effort in addressing maternal and neonatal mortality in the community 6,8 there has been an increase in health facility deliveries (57%) but the total number of neonates dying annually has reduced decimally 7,9 . Previously, global data was used by local poli-cy makers in Uganda to develop newborn survival priorities, local data is very crucial but still very scanty 7 .…”