Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
Reproductive health
Abstract
The slow progress in reducing maternal and newborn death in low and middle-income countries is
attributed to both demand and supply-side factors. This study assessed the changes in maternal and newborn services
in health facilities as well as demand for maternal and newborn health services in Eastern Uganda.
Methods: The health assessment data were collected in August 2013 and September 2015 in the districts of Kamuli,
Pallisa, and Kibuku. We purposively collected data on the availability of services from 40 health facilities that provided
maternal and newborn services. In addition, we conducted 24 focus group discussions (FGDs) with women and men;
and 18 key informant interviews (KIs) with health workers.
Results: On the supply side, most health facilities persistently lacked lifesaving medicines such as misoprostol, IV
Ampicillin, IV Gentamycin, IV Metronidazole, Magnesium Sulphate, Ergometrine, Corticosteroids, ferrous Sulphate,
Folic Acid, Combined ferrous, Benzyl penicillin, and Diazepam (IM or IV). Basic newborn equipment such as stethoscope,
fetal scope, working baby scale, newborn suction devices, newborn resuscitation device, and thermometer
were persistently not available in most of the health facilities. Binders for Kangaroo Mother Care, blanket to
wrap newborn, baby warmer or heat lamp were persistently not available in at least 80% of the health facilities. Other
equipment for the management of labor and abortions such as Manual vacuum aspirator for abortion care, blank
partographs and vacuum extractor were not available in most of the health facilities including referral facilities at baseline
and follow-up. On the demand side, the qualitative interviews exposed long distances and inadequate transport to the
health facilities, inadequate information, poverty, and poor services at the health facilities as major factors that impede
women to utilize/accessmaternal and newborn services.
Conclusion: There are distinct influences on both demand and supply side, which restrain both health care uptake and
its quality. The frequent disparity between the health facility readiness to provide services and the women readiness to
utilize them needs to be addressed as the country intensifies its efforts to reduce maternal and newborn deaths through
boosting facility deliveries.
Description
Keywords
Maternal and newborn, Supply and demand side factors, Health facility readiness, Uganda, sub-Saharan Africa
Citation
Kananura, R. M., Kiwanuka, S. N., Ekirapa-Kiracho, E., & Waiswa, P. (2017). Persisting demand and supply gap for maternal and newborn care in eastern Uganda: a mixed-method cross-sectional study. Reproductive health, 14(1), 1-15. DOI 10.1186/s12978-017-0402-6