Curfew, traditional birth attendants increased maternal deaths in teenage mothers during Covid-19 


Teenage mothers. File photo.

Before the outbreak of Covid 19 pandemic, Dr. Acheka says facility delivery was up to 71% but declined to 69% and most of these mothers happened to be teenagers.

Lira – 26, March 2021: When you are not directly affected or part of this grim statistics, then these figures may not be meaningful to you, but the stark reality is that 443 and 26 are the number of babies and mothers who lost their lives in the process of delivery in Lira district alone, ‘blame it on Covid 19 pandemic’.

“We have seen that there was an increase in the number of prenatal death, the number of prenatal death that we received last financial year was really alarming,” Dr. Edmond Aceka, the acting Lira district health officer (DHO) confesses.

27th March 2019 is the date a 27 years old James Odongo will forever remember, but it comes with nostalgia of sweet pain; it was the date when he held a traditional marriage ceremony for his wife Beatrice Atim with hopes that they would start a family and live happily.

As fate would have it, his wife conceived two months later, and this was a dream come true but little did he knew the sad movements that awaited him.

“This was the best moment of my life; took her for antennal, I even shopped clothes to welcome the new baby in time,” Odongo tearfully tells TND News from his village in Olelpek, Apac sub county, Apac district.

Just a few weeks after government instituted lockdown as a partial measure to curb the fast spread of the novel Coronavirus, Odongo’s wife started experiencing labor pain at night, fear of repression from the local defense personnel enforcing curfew times, and lack of an ambulance to transfer his wife to the nearest health facility spelt doom, and became a dark turning point in Odongo’s life.  He lost both the mother and the child the next morning.

“I felt shivers going down my spines as soon as the medic came and delivered the news to me, my life has never been the same; I feel I have lost everything,” Odongo narrates amid tears.

Odongo is not alone, but this is the pain that a lot of men who have either lost their babies or wives go through and the trauma that they live with on a daily basis.

In an interview with the DHO Lira, Dr.Edmond Aceka, he admitted that maternal and neonatal deaths increased in Lira district in the year 2020-2021 compared to 2019, a scenario he attributed to increase in teenage pregnancies which forced many girls back home following the closure of schools by government and curfew imposed by government.

Before the outbreak of Covid 19 pandemic, Dr. Acheka says facility delivery was up to 71% but declined to 69% and most of these mothers happened to be teenagers. He also explains that the decline in facility delivery was because most traditional birth attendants took advantage of the lockdown situation.

Dr Aceka said most mothers couldn’t move to a nearby health centers due to inability to access transport  means and  fear of breaching  curfew time  as  some of them were beaten while on  boda bodas, hence most of these mothers to just sat back.

“We have seen that there were a number of increases in the parental death, it was really alarming,” Dr Aceka said, adding that this was in the form of macerated and still birth.

According to the World Health Organization (WHO), a baby born with no signs of life at or after 28 weeks’ gestation while macerated stillbirth  is  defined as the intrauterine death of a fetus sometime before the onset of labor, where the fetus showed degenerative changes]as reported in the obstetric records by the attending physician.

Mr Aceka further blames the skyrocketing cases of maternal and neonatal deaths on the advantage taken by traditional birth attendants to deliver mothers in the community.

“…….by the time they reach hospital, the fatuous are already damaged because they start pushing when the time has not yet reached and this made them record,” he laments

Other districts in Lango sub region was not spared as TND News would later find out from Apac district’s Leona Oceng, the District Health Officer who said in a week, they lose about four mothers, in most cases teenagers. This is because, he says, they become anemic and delays in referrals cause their death.

“All these deaths are not from the facility, they are referrals from the lower health facilities, so they delay with the mothers in the community by the time the mother is reaching the hospital, we cannot rescue,” he told TND News

Just like Dr. Aceka complained, Mr Oceng said the traditional birth attendants had been in existence, then government banned their operations but during the lock-down, they emerged thus contributing to maternal deaths.

Lira regional referral hospital has had its fair share of the same predicament as TND News was told that eight mothers lost their lives at the facility between October and November 2020 alone.

Dr Aceka speaks to TND News’ Frank Oyugi.

Attempts to corroborate the above figures was however futile as Dr. Stephen Oboo, the hospital’s administrator instead referred this digital newspaper to Lira district health department.

But a private health expert who requested for anonymity says the surge in maternal mortality especially in teenage mothers was largely because most of the health facilities realigned all their energies on fighting Covid 19 and other sectors including maternal health was ignored.

Much as maternal mortality was rampant among teenage mothers, some cases also involved mothers who had given birth to too many children, the sad reality is that some could have saved their lives by seeking sexual reproductive health services commonly known as family planning but this too has faced vast challenges.

Agnes Apili, a mother of three in Ibuje, Apac district says most times when they got to seek for family planning services, they don’t find the nurses on duty while some are arrogant and use vulgar languages on them to the extent of naming them as “prostitutes” as she tells more in this clip.

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According to UNICEF report, the first 24 hours and the first six days of life are the most critical for newborn survival. At least 45,000 newborn deaths occur each year and an equal number are stillborn. Uganda’s neonatal mortality rate (NMR), possibly an under-estimate, is very high at 29 deaths per 1,000 live births, has not declined over a period of 15 years.

More newborn deaths occur at home, among the rural poor, internally displaced persons (IDP) camps and in western and central regions. The common causes of neonatal deaths in Uganda are similar to the rest of Africa and include birth asphyxia, infections and complications of preterm birth. Underlying causes of death are related to poor access and utilization of health services during pregnancy and childbirth, especially the high number of deliveries that take place without skilled attendance.

Education sector not spared either

In 2018, Lira district alone recorded over 5000 cases of teenage pregenancy,the figure further skyrocketed close to 22000 as per the data availed by Lira district local government authorities and in 2020, a total of 6,149 pupils  registered for Primary Leaving Examinations (PLE) at the 110 centers in both government and private headed primary schools in Lira District.

But according to Patrick Olwit Ogwang, the Lira District Inspector of schools, at least 845 candidates did not report back to school even after government allowed classes for finalists and he attributes the high number of school drop outs to child marriages and lock down which found people in different parts of the district.

This story was produced with support from Ultimate Media Consults


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