6 Improve maternal health

Where we are?

Protecting mothers and their babies is key for achieving both MDG 4 & 5. (UNDP Uganda 2009)
  • In 2006, 42% of all the births were done by skilled health personnel. However, there is disparity between the urban areas and rural areas’ accessibility to a skilled health worker. More than 85% of births in the urban areas were attended to by skilled health personnel in contrast to the 40% in rural areas.
  • About 55% of pregnant women attended the recommended four antenatal visits in urban areas while in rural areas the average was a little more than 40%
  • As per the 2013 report, Uganda has the highest percentage (38%) of women with unmet needs for family planning. Women with unmet needs for family planning are those who wish to delay pregnancy, are sexually active and yet do not use any family planning method.

Although there was stagnation in progress in maternal health between 1995 and 2001, accelerated progress was observed in 2006. According to the data collected in the Uganda Demographic Health Survey (UDHS), the maternal mortality ratio stagnated at 506 per 100,000 births in 1995 and 505 in 2001, but has since declined to 435 in 2006. This suggests that the incidence of maternal mortality is declining. However, it is clear that the decline has not been fast enough to ensure that Uganda is on track to meet MDG 5. These trends should be interpreted with caution, however. As highlighted by UBOS and the Ministry of Health in the 2007 UDHS report, the methodology used and the sample sizes implemented in the three surveys do not allow for precise estimates of maternal mortality. The errors that follow from the representative sample around each of the estimates are large and, consequently, the changes are not statistically significant. It is therefore not possible to say confidently that maternal mortality has declined.

A decline in the maternal mortality ratio will be accelerated by improvements in other related indicators, such as antenatal care coverage, delivery in health facilities, and medical assistance at delivery, all of which have improved only marginally over the last ten years. Most notably, the share of births that were attended by skilled health personnel merely increased from 35% to 44% in the decade after 1995. This national average masks great inequalities across the population. Among the poorest 20% of the population, the share of births attended by skilled health personnel was 29% in 2005/2006 compared to 77% among the wealthiest 20% of the population. There has been a slight improvement in the situation for the poorest households, though, and the Government is committed to sustaining and accelerating this progress.

Targets for MDG 5
  1. Reduce by three quarters the maternal mortality ratio
    • Most maternal deaths could be avoided
    • Giving birth is especially risky in Southern Asia and sub-Saharan Africa, where most women deliver without skilled care
    • The rural-urban gap in skilled care during childbirth has narrowed
  2. Achieve universal access to reproductive health & inadequate funding for family planning is a major failure in fulfilling commitments to improving women’s reproductive health
    • More women are receiving antenatal care
    • Inequalities in care during pregnancy are striking
    • Only one in three rural women in developing regions receive the recommended care during pregnancy
    • Progress has stalled in reducing the number of teenage pregnancies, putting more young mothers at risk
    • Poverty and lack of education perpetuate high adolescent birth rates
    • Progress in expanding the use of contraceptives by women has slowed & use of contraception is lowest among the poorest women and those with no education