Experts Want E-registry Piloted in Busoga Hospitals Rolled out Countrywide

Scientists have asked the government to adopt simple data collection methods in hospitals across the country if they are to cut down on the death of mothers and their babies during delivery or shortly after.

The researchers, who conducted a study in selected hospitals in the Busoga region in Eastern Uganda where they introduced a perinatal e-registry, which had every mother’s data tracked right from pre-hospital admission until discharge and after, saw positive outcomes in the region.

Busoga currently has the country’s worst neonatal and maternal health indicators. Speaking to URN in an interview, Dr. Elizabeth Ayebare, a Co–Investigator in the study, said they aimed to have this data collected by midwives using mobile gadgets where they would assess and record the state in which the mother is admitted, their labor progress, child birth and the kind of post-natal care they receive.

In their registry, the researchers are collecting data, on how many babies die during birth and those that die shortly after birth using small gadgets such as mobile phones. The doctor says without such data, it would be hard to determine what is killing mothers and babies more and how this can be reversed.

Currently, nationwide maternal mortality is estimated at 284 women per 100,000 according to data by the Ministry of Health, and neonatal mortality at 29 deaths per 1000 live births.

One of the biggest causes of maternal mortality for instance is bleeding, high blood pressure during pregnancy, and infections but according to Prof Peter Waiswa, a lecturer and researcher based at Makerere University School of Public Health (MAKSPH) this data can not be relied on for accurate health decisions as the country has noted collected such data for seven years now.

He says the status of key health indicators is currently unknown as the government has delayed by two years to conduct a demographic health survey which gives a picture of how the country is doing to guide interventions.

When it comes to new born health, Waiswa who has been doing wide research in maternal and child health says a situational analysis was last done fifteen years ago.

“We don’t know the country’s estimate now, we don’t know how well we are doing and how to improve”.

However apart from Busoga, this study which is titled ALERT short for Action Leveraging Evidence to Reduce Perinatal Mortality and Morbidity is also being done in Malawi, Benin, and Tanzania.

In Uganda at baseline, researchers who among others assessed data collection mechanisms, health worker skills, and behaviors in maternity wards found a lot of missing data on referral of mothers and information on the state of mothers and babies at the time of discharge from hospital.

Ayebare says that less than 50% of hospitals had protocols and guidelines for referral in place and mothers reported that only 35% of health workers entertained questions from mothers during admission.

She also noted that 3.5% of mothers reported being slapped or pinched by health workers. This is although the World Health Organisation (WHO) is recently pushing for respectful maternity care as one of the simple ways to improve child birth outcomes.

Commenting on this research, Dr. Othiniel Musana, the President of the Association of Obstetricians and Gynecologists of Uganda told URN that real-time collection of data is not just important for mothers and babies but also good for improving accountability in hospitals to tame the long challenge of absenteeism.

While the government has for long struggled to go electronic even at the national referral hospital in Mulago which is still largely paper-based, Musana says the government could adopt such simple but tested efficiency innovations.

Meanwhile, according to Prof Claudia Hanson a senior Lecturer at Karolinska Institutet who is the overall Principal Investigator in all the four countries conducting this ALERT study, in Uganda while mothers are now and increasingly delivering in the health facilities, the country still has a long way to go to stop maternal deaths if funding of hospitals remains as is.

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