Communities to monitor and improve health service delivery by reporting wrongdoings

The following article has been provided by Mercy Apio Ogema at Indigo grantee WOUGNET

mercyAccess to health care in many public hospitals is still wanting, especially in rural parts of Uganda. Many health centres are understaffed, have inadequate drug stocks, limited facilities and medical supplies and hidden costs. These are all barriers that hinder people accessing health services. It is partly due to these reasons that some mothers opt to give birth from their homes, while others may not have the money to pay for services rendered to them.

Like many other health centres, Agulurudde health centre is understaffed. It has three trained medical personnel and a handfu of support staff, despite the fact that the centre is supposed to have 19 staff.  Pregnancy, whether planned or unintended, is often a key entry-point into the health system, and midwives should provide a welcoming doorway. They should introduce women to the health system and ensure that women and their babies receive a variety of skilled care during pregnancy, childbirth, and in the important days and weeks after birth.

It was during a quarterly meeting held on 2nd July 2013 that WOUGNET’s Information Officer, Mercy  Apio  Ogema, arrived at Acan Pii Parish, Loro Sub- County in Oyam district, Northern Uganda. She was there to find out about some of the problems that the Agulurudde health centre had been experiencing. The WOUGNET contact there noted that there was a very rude midwife who was harassing pregnant women especially those who were in labour. Some were sent away having been told that they were not in labour, only to then give birth at home. A case in point is of one mother who was experiencing labour pains and was admitted at the health center. However, as she was not giving birth the midwife discharged her. At home that very night, the woman went into labor and delivered alone in the house.  Her husband was not home that night and the health facility was far from home. She immediately developed complications that were reported to a WOUGNET contact there who rushed her back to the health centre. The very same midwife who had earlier refused her treatment said that she could not treat the woman as she had not given birth at the health centre. Fortunately, a member of the WOUGNET voluntary social accountability committee pressured the midwife into calling an ambulance which transferred mother and baby to another hospital.

This is but one example of misuse of public health facilities and poor service delivery uncovered by WOUGNET’s network. It’s also a reminder of the importance of action at the very local level. WOUGNET have since followed up on these and other reports with local officials responsible for health services in the area. Knowing that they are not immune from criticism will hopefully spur them on to dealing with some of the many problems that health centres in this part of Uganda are facing.