Department of Obstetrics & Gynaecology
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Item 59-year-old gives birth to 3 babies, loses 2(New Vision, 2018-04-03) Nakajubi, GloriaOne of the babies died in the uterus while the other two died due to lack of enough oxygen at Mulago.Item Babies dying due to oxygen shortage at Kawempe Hospital(New Vision, 2018-04-03) Nakajubi, GloriaFor a 59-year-old first time mother, the news that two of her three babies had been delivered had died, was heartbreaking. Namakula Magdalene, resident of Mubende district is only hoping that her remaining child survives.Item Buliisa, Hoima men shun antenatal visits(New Vision, 2018-06-08) Atuhairwe, RobertHealth officials in the districts of Buliisa and Hoima have expressed concern over the failure by men to accompany their expectant wives to health facilities for antenatal care services.Item Catching babies, carrying traditions : the voices and practices of traditional birth attendants in Mayuge District, East central Uganda.(BMC, 2025) Kagoya, Enid Kawala; Auma, Proscovia; Mugabi, Joshua; Kawala, Elizabeth; Asabawebwa, Deogratias; Mugahi, Richard; Mutunda, Brenda Doreen; Gamubaka, Richard; Namaganda, Agnes; Nsubuga, Allan G.; Akello, Jackline; Waako, Paul; Mugabe, KennethBackground: Traditional Birth Attendants (TBAs) continue to support maternal and newborn care in rural Uganda, particularly where access to formal health facilities is limited. Their roles are deeply embedded in local culture and community trust, yet national policies provide inconsistent guidance on their engagement within the formal health system. Objective: To explore the evolution, experiences, practices, challenges, and perceived support needs of TBAs in Mayuge District, and examine their interaction with formal health structures. Methods: A qualitative narrative study was conducted with 15 purposively selected TBAs from all sub-counties of Mayuge District. In-depth interviews lasting 60 to 90 min were held at participants’ homes or workplaces. Participants described and demonstrated their maternal care practices. Audio recordings were transcribed, translated, and analyzed thematically. Results: Seven key themes emerged from the study: (1) Historical Developments and Evolution of TBAs, highlighting diverse pathways into practice such as apprenticeship, family mentorship, formal Ministry of Health training, and community programs; (2) Practices, Methods, and Approaches, detailing TBAs’ provision of antenatal, delivery, and postnatal care, and management of maternal and newborn complications using both traditional and modern methods including newborn resuscitation; (3) Infection Prevention and Control, revealing variable use of personal protective equipment and inconsistent waste disposal practices constrained by limited resources; (4) Maternal and Perinatal Death Surveillance and Response (MPDSR) Process, illustrating TBAs’ limited participation in formal death notifications and reviews; (5) Referral Process, highlighting complex referral behaviors involving health facilities, fellow TBAs, and traditional healers; (6) Socio-Cultural Influences on TBA Services, encompassing the impact of poverty, gender roles, community trust, and cultural norms; and (7) Challenges in Providing Safe and Effective Care, including barriers such as negative attitudes from health workers, transport difficulties, competition, and lack of formal support. Conclusion: TBAs in Mayuge District play a vital role in culturally grounded maternal care but face numerous challenges due to limited formal integration and support. Strategies are needed to strengthen collaboration, provide targeted training, and clarify policy to improve maternal and newborn health outcomes in underserved areas. Keywords: Traditional birth attendants, Maternal and newborn health, Socio-cultural determinants, Referral practices, Health system integration, Rural ugandaItem Covariates of pica among pregnant women attending antenatal care at Kawempe hospital, Kampala, Uganda: a cross-sectional study(The American Society of Tropical Medicine and Hygiene, 2021) Nakiyemba, Olivia; Obore, Susan; Musaba, Milton; Wandabwa, Julius; Kiondo, PaulPica is the craving and purposive eating of nonfood items. It is common worldwide and presents among vulnerable populations like children and pregnant women. Its etiology and health consequences are not well understood. The aim of this study was to determine the prevalence and covariates of pica among pregnant women attending antenatal clinic at Kawempe hospital in Uganda. We conducted a cross-sectional study from July 2019 to December 2019. Participants in this study were 307 pregnant women who had come to attend antenatal clinic at the hospital. The prevalence of pica was computed. Bivariate and multivariable analysis was done to establish the factors that were independently associated with pica. The prevalence of pica was 57%. The most common type of pica was geophagia (eating clay and sand) followed by pagophagia (eating ice). Of the women who practiced pica, half consumed the nonfood items daily. Factors independently associated with pica were being in the third trimester (adjusted OR [aOR]: 3.60; 95% CI: 1.36–9.48] and having nausea in pregnancy (aOR: 2.11; 95% CI: 1.20–3.70). At Kawempe hospital, pica is common among women who attend the antenatal clinic and is associated with having nausea in pregnancy and being in the third trimester. Health workers need to counsel pregnant women about the dangers of pica so as to reduce helminth infections and micronutrient deficiency associated with it.Item Doctors get machine to save newborns(Daily Monitor., 2018-03-08) Namagembe, LilianIn a move to reduce the number of newborns dying from breathing failure at birth, researchers have come up with a more advanced resuscitation device to sort out the problem. At least one in every 10 children born needs resuscitation at birth, according to Ministry of Health.Item Effect of pre-operative bicarbonate infusion on maternal and perinatal outcomes among women with obstructed labour in Mbale hospital: A double blind randomized controlled trial(PLOS One, 2021) Musaba, Milton W.; Wandabwa, Julius N.; Ndeezi, Grace; Weeks, Andrew D.; Mukunya, David; Waako, Paul; Nankabirwa, Victoria; Tulyamuhika Mugabe, Kenneth; Semakula, Daniel; Tumwine, James K.; Barageine, Justus K.Introduction Oral bicarbonate solution is known to improve both maternal and perinatal outcomes among women with abnormal labour (dystocia). Its effectiveness and safety among women with obstructed labour is not known. Objective To determine the effect and safety of a single-dose preoperative infusion of sodium bicarbonate on maternal and fetal blood lactate and clinical outcomes among women with obstructed labour (OL) in Mbale hospital. Methods We conducted a double blind, randomised controlled trial from July 2018 to September 2019. The participants were women with OL at term (>37 weeks’ gestation), carrying a singleton pregnancy with no other obstetric emergency, medical comorbidity or laboratory derangements. Intervention A total of 477 women with OL were randomized to receive 50ml of 8.4% sodium bicarbonate (238 women) or 50 mL of 0.9% sodium chloride (239 women). In both the intervention and controls arms, each participant was preoperatively given a single dose intravenous bolus. Every participant received 1.5 L of normal saline in one hour as part of standard preoperative care. Outcome measures Our primary outcome was the mean difference in maternal venous blood lactate at one hour between the two arms. The secondary outcomes were umbilical cord blood lactate levels at birth, neonatal sepsis and early neonatal death upto 7 days postnatal, as well as the side effects of sodium bicarbonate, primary postpartum hemorrhage, maternal sepsis and mortality at 14 days postpartum. Results The median maternal venous lactate was 6.4 (IQR 3.3–12.3) in the intervention and 7.5 (IQR 4.0–15.8) in the control group, with a statistically non-significant median difference of 1.2 mmol/L; p-value = 0.087. Vargha and Delaney effect size was 0.46 (95% CI 0.40–0.51) implying very little if any effect at all. Conclusion The 4.2g of preoperative intravenous sodium bicarbonate was safe but made little or no difference on blood lactate levels.Item Factors associated with longer hospital stay following caesarean section birth at a tertiary hospital in Eastern Uganda.(Research Square, 2025) Thaddeus, Jude Mulowooza; Tweheyo, Ronald; Babuya, Jonathan; Atuhairwe, Irene; Makoko, Brian Tonny; Waako, Paul; Twineamatsiko, Andrew; Agaba, Brian; Stephen, Obbo; Kavuma, Pontian Kiwanuka; Kibuule, Dan; Kayemba, Frank; Kagoya, Enid KawalaBackground. Caesarean Section(C/S) is a lifesaving procedure for both the mother and the baby but it is associated with various post-operative complications and longer hospital stays. Prolonged Hospitalization after a Caesarean section can be stressful for both the healthcare providers and the mothers while also risking them acquiring hospital acquired infections. Factors related to longer hospital stays among mothers delivered by C/S have not been well explored. This study aimed to determine the factors associated with longer (> 4 days) hospital stay following Caesarean birth at Mbale Regional Referral Hospital. Methods This was a retrospective cross-sectional study carried out at Mbale Regional Referral Hospital (MRRH) between December 2023 and May 2024 accessed in June 2024. A total of 536 patient files of women who underwent Caesarean section were randomly selected and reviewed. Data on social demographics, obstetric characteristics and other surgical details including outcomes was extracted and recorded using an online data collection tool. Descriptive analysis to summarise the data and logistic regression to identify factors associated with longer hospital stays were done, and P-values < 0.05 significance level at a 95% confidence interval were considered. Results The mean hospital stay was 4.02 days (SD ± 2.87). Nearly half of the women (47.6%) were referred from other health facilities with most caesarean sections (70.9%) sanctioned by junior house officers. Preoperative prophylactic antibiotics were administered in 85.4% and spinal anaesthesia was used in 98.5% of the Csections. In multivariable analysis, lack of a complete blood count, vaginal preparation, intravenous fluids before surgery and a patient undergoing general anesthesia were significantly related to longer hospital stays. Conclusion Multiple factors are associated with longer hospital stays at Mbale Regional Referral Hospital. Improvement of evidence-based practices such as the intravenous fluids, vaginal preparation and basic laboratory investigations before surgery and use of spinal anesthesia can help to reduce hospital stay and its associated risks. Keywords: Caesarean section, longer hospital stay, postoperative complicationsItem Family planning: Empowering women to be productive(New Vision, 2017-07-11) Kyotalengerire, AgnesA woman who is informed about Family planning will decide on which method to use, to enable her produce the number of children she can take care of.Item Fistula: What Uganda needs to end the condition(New Vision, 2018-05-23) Kyotalengerire, AgnesToday Uganda joins the rest of the world to commemorate the international Fistula Day under theme: End Fistula now, reach everyone. The commemoration aims at raising awareness, visibility of obstetric fistula and intensifying actions towards ending the condition in Uganda and the world over. Agnes Kyotalengerire explores what the Government is doing to eliminate thee backlog of 75,000 to 100,000 patients who are not treated.Item Incidence and determinants of perinatal mortality among women with obstructed labour in eastern Uganda: a prospective cohort study(Springer Nature, 2021) Musaba, Milton W.; Ndeezi, Grace; Barageine, Justus K.; Weeks, Andrew D.; Wandabwa, Julius N.; Mukunya, David; Waako, Paul; Odongkara, Beatrice; Arach, Agnes; Tulya-muhika Mugabe, Kenneth; Kasede Napyo, Agnes; Nankabirwa, Victoria; Tumwine, James K.Background: In Uganda, the incidence and determinants of perinatal death in obstructed labour are not well documented. We determined the incidence and determinants of perinatal mortality among women with obstructed labour in Eastern Uganda. Methods: Between July 2018 and September 2019, 584 with obstructed labour were recruited and followed up to the 7th day postnatal. Information on maternal characteristics, obstetric factors and laboratory parameters was collected. Each patient received the standard perioperative care. We used a generalized linear model for the Poisson family, with a log link and robust variance estimation to determine the association between the exposure variables and perinatal death. Results: Of the 623 women diagnosed with obstructed labour, 584 met the eligibility criteria. There were 24 fresh still births (FSB) and 32 early neonatal deaths (ENND) giving an FSB rate of 43.8 (95% CI 28.3–64.4) deaths per 1000 total births; early neonatal death rate of 58.4 (95% CI 40.3–81.4) deaths per 1000 and an overall perinatal mortality rate of 102.2 (95% CI 79.4–130.6) deaths in the first 7 days of life. A mother being referred in active labour adjusted risk ratio of 2.84 (95% CI: 1.35–5.96) and having high blood lactate levels at recruitment adjusted risk ratio 2.71 (95% CI: 1.26–4.24) were the determinants of perinatal deaths. Conclusions: The incidence of perinatal death was four times the regional and national average. Babies to women referred in active labour and those with high maternal blood lactate were more likely to die. Keywords: Obstructed labour, Perinatal death, Determinants, LactateItem Jinja porter aids neglected mother to give birth(New Vision, 2017-07-31) Nambogga, JackieThe Jinja district chairperson has instructed the Chief Administration Officer (CAO), Olive Nakyanzi together with the District Health Officer (DHO), Dyogo Nantamu, to probe a health officer who allegedly neglected a mother in labour. According to Titus Kisambira, the mother was instead aided by a porter to give birth.Item Lango region women lack access to maternal healthcare services(Daily Monitor, 2017-10-11) Oketch, BillMost of the women in Lango sub-region are complaining of harsh treatment at health centres, while a few mothers claim they are often left to deliver on their own.Item Maternity leave not a favour, government tells private employers(New Vision, 2018-05-01) Kasujja, CarolAs Uganda joins the rest of the world in commemorating International Labour Day today, the Ministry of Labour, Gender and social Development has instructed all private companies to grant mothers paid maternity leave.Item Mayuge decry low access to maternal services(New Vision, 2017-08-02) Angatai, BettyNineteen-year-old Annet Namuwaya, a mother of one, lost her baby when she delivered at home. she could have saved the baby, had she delivered at a health facility.Item Medics root for supplies to curb newborn deaths(Daily Monitor, 2018-05-01) Agaba, VivianHealth workers have asked government to provide more medical supplies to attend to babies born with breathing difficulties, a step that will see a reduction in neonatal deaths.Item Men stay away from antenatal visits(Daily Monitor, 2018-05-07) Muwulya, MosesMasaka Hospital authorities have raised a concern over increasing number of expectant mothers who seek antenatal services without being accompanied by their spouses. The men are reportedly shying away for fear of a compulsory HIV/Aids testing carried out at the facility.Item Namayumba health centre overwhelmed with expectant mothers.(New Vision, 2018-05-24) Nabantazi, VioletNamayumba Health Centre IV in Wakiso district is overwhelmed with the number of expectant mothers. Over 100 mother deliver from the facility every month, yet it is meant for only 20 mothers.Item Only 40% of children get proper medication - report(Sunday Vision, 2017-07-30) Masaba, JohnUganda's campaign to cut back on mortality figures of children under five years could be under threat, after a new study conducted on health facilities in the country showed that less than half of the children who visit hospitals get proper medical attention.Item Parents tipped on preventing fistula(New Vision, 2018-05-21) Nantambi, Agnes; Kyotalengerire, AgnesDr Jackson Amone, the commissioner for curative services at the health ministry has advised parents to keep their girls in schools as a means of preventing fistula. " We need to prevent obstetric fistula by sensitising young girls to stay in schools, avoid early marriages and produce at the right age," said Amone.