1. By: Maria Jorgensen

2. Uganda has a high maternal mortality ratio, typical of many countries in sub-Saharan Africa, with an estimated 505 maternal deaths per 100,000 live births.

3. The prevailing high rates of fertility (6.7 births per woman), in an environment of poor access to quality maternal and neonatal care, have continued to expose Ugandan mothers and infants to a high risk of death from pregnancy related causes, with an estimated 1 woman in 10 dying from maternal causes in Uganda (the lifetime risk).

5. Some of the contributing factors to the high maternal mortality rate in Uganda have been found to include:  Poor fertility regulation of early pregnancy in adolescents, short pregnancy intervals and a generally high total fertility level. This has been in part due to an overall low use of contraceptives.  Limited capacity of health facilities to manage abortion/miscarriage complications, despite it being a major contribution to maternal morbidity and mortality  Of the 97 health units studied, only 40% were able to manage the complications of abortion.

6.  There was also poor service availability for post abortion care, ranging from inadequate skills to lack of equipment, supplies and drugs in most health units ;  Prevalence of HIV/AIDS among pregnant women has also been a factor in poor maternal outcomes. It is presumed that the prevalence of HIV infection peaked in 1992 for many areas, then declined to its current level, estimated in 2001 to be 6.1% of Ugandan pregnant mothers. According to one study, 26.5% are assumed to transmit the infection to their babies. Although AIDS continues to be a major health problem in Uganda, HIV incidence (new infections per year) does seem to be declining in parts of the country.  Malaria is one of the leading causes of morbidity in pregnant women but prevention and prophylaxis services are not well established.

7. POLITICAL ENVIRONMENT  Poverty reduction through improving human capacity  National Programs  Safe motherhood Programme (SMP)  Builds supportive networks of birth attendants as a backup for maternal health systems  Bulilds interventions to determine high risk births  Strengthen referral systems  National Population Policy  Reduce fertility and maternal morbidity and mortality by:  Promoting informed choices,  Service accessibility  Improved care quality  National Gender Policy  Goal to integrate gender into national developments.  Empower women through decision making processes

8.  National Policies  Universal Primary education  Improve population literacy  Increased school enrollment for both boys and girls  Long term outcome of increasing the maternal and reproductive health of that generation  Adolescent Health Policy:  promotes adolescent friendly services, sex education and building life skills.

9.  Forty-nine percent of the Ugandan poulation lives within 5 km of a health facility  33% of helath facilities in the country do not provide maternity services  Only 57% of hospitals were equipped to administer general anaesthesia

10.  The Ugandan Government needs to continue to improve the health of it’s mothers in order to silence this rampant problem.

11.  Increasing access and quality of health care  Increasing sex education at both the youth and adult age groups  Increasing literacy  Advocate for pre natal and ante natal health care services

12.  The country has a high fertility rate, contraception use is low, and its population is one of the fastest growing in the world.  The maternal mortality ratio has declined by 36 percent since 1990, but remains high.  The Government has made maternal and child health a development priority, and has launched a road map for the reduction of maternal and newborn mortality.  More must be done

13.  Department of Human Services: Uganda. (1995). Demographic and Health Survey. Department of Human Services. Retrieved September 15, 2014, from http://www.dhsprogram.com/pubs/pdf/SR148/SR148.pdf  Jacobsen, K. H. (2014). Introducation to Global Health (Vol. 2). Burlington, MA, United States: Jones and Bartlett. Retrieved September 3, 2014  Ssengooba, F., Neema, S., Mbonye, A., Sentubwe, O., & Onama, V. (n.d.). Maternal Health Review Uganda. Makerere University Institute of Public Health, Health Systems Development Programme, 1-40. Retrieved 18 2014, September, from http://r4d.dfid.gov.uk/pdf/outputs/healthsysdev_kp/04- 03_uganda.pdf  (2011). The State of the World's Midwifery: Uganda. The State of the World's Midwifery. Retrieved from http://www.unfpa.org/sowmy/resources/docs/country_info/profile/e n_Uganda_SoWMy_Profile.pdf  World Health Organization. (2012). World Health Statistics: Global Health Indicators. World Health Organization. Retrieved from http://www.who.int/healthinfo/EN_WHS2012_Part3.pdf