Maternal and Perinatal death among pregnant mothers are a major concern in Uganda and one of the objectives of Ministry of Health is to improve the care of mothers and new born in order to achieve Millennium Development Goal 4 (MDG4) which focuses on reduction of infant and maternal deaths.

Following the number of maternal perinatal death in hospitals and other health units, it was found out by the Maternal Deaths Review Committee of Apac main hospital that some of those deaths could have been prevented by creating awareness to the mothers, husbands, community and community leaders at all levels.

As a rural information center that serves as an agricultural resource bank with appropriate local content in a variety of formats, the center also offers other information about health, small business, small loan and village saving initiative, gender and other social issues targeting the general community of northern region.

This information is disseminated through field visits, training programs, weekly radio talk shows and by clients visiting the centre. It is upon this that Kubere Information Center (KIC) in partnership with Apac Hospital and the community radio-Apac FM organized and sensitized the general community to create awareness on the causes of Maternal and infant mortality and how this can be prevented in the community.

Broad Objective of the talk show;

·         To reduce maternal and perinatal death among mothers and new born.

Purpose of conducting the Radio talk show was to;

To create awareness among the community, policy makers and health professionals on the following;

·         Causes of maternal and perinatal death

·         Prevention of maternal and perinatal death

·     To stimulate actions to address these avoidable factors and prevent further maternal death

What is maternal and perinatal death?

Maternal death is death of a woman while pregnant or within 42 days of termination of pregnancy irrespective of duration and the site of pregnancy from any related cause or aggravated by pregnancy or its management but not from accidental or incidental causes.

Perinatal Death

Death that occurred around the time of birth, these include still birth and early neonatal death.

Still Birth

This is death prior to the complete expulsion or extraction from a mother of its fetus/baby of 1000 grams or 28 weeks of gestation. This is evidenced by the fact that the fetus does not show any signs like breathing, heart beat, pulsation of the umbilical code or voluntary movement of muscles.

Causes of maternal death

These are the major causes of maternal death approved by Ministry of Health (MOH) include the following;

·         Hemorrhages (Bleeding) during and after delivery

·         Injection/sepsis

·         Hypertension

·         Obstructed labor

·         Unsafe abortion

·         HIV/AIDS

·         Malaria

Pre Disposing Factors

Pre disposing factors are those things surrounding us and responsible factors that determine our stander of living, below are some of pre deposing factors;

·         Poor socio-economic living condition among house holds

·         Poverty

·         Ignorance of the community

·         Excessive fertility of high risk plenary

·         Lack of community services

·         Poor attitude of health workers toward pregnant mothers

·         Non male involvement

Danger signs for Maternal and Perinatal Death

1. Bleeding

·         In Ante Partum Hemorrhage (APH) at 28-37 weeks

·         Post Partum Hemorrhage (PPH) after delivery

2. Early rapture of membranes

·         Draining of liquor (Amniotic fluids the keep the unborn baby in the worm)

·         Edema of face and limbs during pregnancy

·         Severe headache

·         Fever during pregnancy, labor and after birth

·         Excessive vomiting

·         Anemia during pregnancy and after delivery

Management and Prevention of Maternal and Perinatal Death

The management and prevention of Maternal and Perinatal death among pregnant women before and after delivery has been geared towards different sector’s involvement, these include the following;

1.      Community and community leaders

2.      Husband/spouses

3.      Opinion/political leaders

4.      Traditional Birth Attendants (TBA) and Village Health Team (VHT)

5.      Health workers

Community/Community Leaders

The following are some of the roles of our community/community leaders in the management and prevention of Maternal and Perinatal death among mothers and their babies.

·         Change attitude about pregnancy that is normal and yet each pregnancy stands its own risk

·         Teaching, convey results message on AMC attendance at four times (4) during pregnancy

·         Change from old culture

·         Rest for 2hours during the day and 8hours at night

·         Eat a balance diet (local food)

·         Enforce girls to avoid early pregnancy and marriage

·         Well informed woman is able to care for her self and child properly compare to un educated

Mother
Has mothers, it is important and advisable to attend Antenatal care (ANC), early and more than three times before delivery as this will enable the medical team time to examine what is taking place between you and the un born baby, therefore, three antenatal care is advisable within a time interval as below;

1^st – attend ANC before 16 weeks

2^nd – attend ANC between 7 to 8 months before delivery

3^rd – attend ANC in the 9 months, until delivery

·         Take all medicine given from a health unit by qualified health workers as instructed

·         Report any problem or illness to a health worker

·         Have a good dialogue with your spouses

·         Inform husband when not feeling well

Husband                                                                  
In an attempt for husbands to manage and prevent Maternal and Perinatal death among mothers and their babies, the following are advisable;

·         Plan for pregnancy

·         Have discussion with your wife all the time

·         Decide together and practice Family planning

·         Give time for wives to rest after birth

·         Support wives during pregnancy and after delivery i.e. Ante-natal care, labor and doing breast feeding

·         Detect problems and report them to health workers immediately

·         Accompany wives to a health facility during Ante-natal, labor and birth

Health Worker

Health workers are very important in ensuring that our lives are good and healthy, and they play a key role in the management and prevention of Maternal and Perinatal death among mothers and their babies. Therefore, as a health worker your are advisable to do the following;

·         Be self motivated

·         Show commitment

·         Detect complications early and refer

·         Good communicate to mother and husband

·         Good customer care

·         Refer immediately if can not handle

·         Document all finding detected during history taking and examination.

·         Follow the correct procedure of handling a mother during pregnancy, labor and after delivery.

·         Team work

Opinion Leaders/ Political Leaders

·         Support health sectors

·         Lobby for funds

·         Co-operate with health workers

Traditional Birth Attendant (TBA)/Village Health Team (VHT)
These are community health workers who work with community down the grass root, they also help so much in ensuring that community are living healthy live, they are so close to community and all the time ready to work with community. Has a TBA/VHT your are advice to do the following;

·         Have a register of all pregnant mothers in your area

·         Visit mother (home visit) and know their status regularly

·         Give advice on importance of attending ANC early and at least 4 times during pregnancy

·         Advice on delivery in health units under the supervision of a health workers

Stake Holders

·         Recruit more midwives and medical personnel

·         Refresher courses for midwives