Getrude, a health worker at Buwasa Health Center IV attends to a pregnant Monica. Photo credit: Irene Mirembe

Monica, a 36-year-old pregnant mother from Uganda’s Sironko district, hesitated to seek prenatal care at Buwasa Health Center IV after hearing about its poor reputation. The facility in Bugisu subregion faced management challenges and service gaps which adversely impacted the quality of patient care.

After a maternal death occurred at the health center, the URC-led USAID Uganda Health Activity (UHA) supported a confidential inquiry into the death by Uganda’s Ministry of Health. That investigation, detailed in the Report from Buwasa Health Center IV Confidential Inquiry into a Maternal Death, identified the care deficits that contributed to the mother’s death.

In response, a new facility in-charge implemented internal control measures to improve quality of care, including weekly performance reviews, frequent midwife duty rotations, and patient privacy arrangements. UHA also supported training for health center staff in essential newborn care and activated the maternal perinatal death surveillance and response (MPDSR) system committee to investigate each maternal and perinatal death.

The health center established a special antenatal clinic for women with high-risk pregnancies, aiming to detect and manage complications earlier, and the facility participated in national quality improvement collaboratives with other health centers.

Similar interventions have been implemented by UHA in all its implementation regions.

The new leadership and implementation of the inquiry recommendations have changed our attitude and improved service quality here. We are all proud of this,” said Gertrude, the Nursing Officer at Buwasa Health Center IV.

When Monica heard of the improved service delivery, she regained confidence to return to the health center, where she delivered a healthy baby.