Namutumba expectant mothers shun health facilities to hide HIV status from husbands

Expectant mothers in Namutumba District, Eastern Uganda are reportedly shunning antenatal visits and delivering from government health centres because they fear breaking the news of their HIV status to their husbands.
Ms Scovia Yolyanaye, a midwife at Bugobi Health Centre II, said HIV positive mothers do not want to deliver from government and private health centres, and have instead opted for Traditional Birth Attendants (TBAs).
 
“The women sweet-talk their husbands to take them to TBAs who will not test for HIV/AIDS, while at the same time fronting delivering at a health centre as being expensive,” Ms Yolyanaye said on March 11.
 
TBAs in Namutumba District are said to be very cheap and sometimes help expectant mothers to deliver at no cost as opposed to midwives who reportedly charge between Shs7,000 and Shs10,000.
 
According to Ms Yolyanaye, the biggest number of mothers who die while giving birth at the hands of TBAs, according to their records, are those living positively.
 
Ms Yolyanaye suggested that an expectant mother is supposed to have up to eight antenatal visits throughout her nine-month-long pregnancy, and decried those who only make one visit and wait for the time to give birth.
 
A mother, who had paid an antenatal visit to one of the health facilities, but asked to remain anonymous for fear of being mistreated by the health workers, said midwives and nurses lack professionalism because they disclose the expectant mothers’ HIV status to their spouses.
 
Ms Betty Nambi, a midwife at Magada Health Centre III, said some mothers go for antenatal visits in their last trimester of pregnancy, which “shows lack of preparation”.
 
“More effort should be put on mothers by encouraging them to go for antenatal checkup. During antenatal visits, we do a number of tests, including HIV/Aids to know whether the mother is positive or negative for proper management,” Ms Nambi said.
 
The above concerns follow a new report which has cited lack of ambulances, failure of mothers to make antenatal visits and increased number of TBAs as causing maternal deaths in Namutumba District.
 
According to findings of the report, which was carried out by health workers in government and private health facilities over a two-year period, two expectant mothers die after every two months.
 
Of the two mothers, the report says one dies while giving birth at the hands of TBAs, and the other while on the way to a health facility because of fatigue.
 
Subsequently, private health workers have joined their government counterparts to devise possible best practices to curb maternal deaths in the district.
 
These include; attracting expectant mothers to visit health facilities, providing alternative means of transport to handle emergency trips, especially referral cases, and helping mothers to make the right decisions to deliver in health facilities.
 
Dr Daniel Kajubi of Namutumba Community Hospital, said maternal deaths in the district are high, adding that almost after every two weeks, mothers die in the villages, but such cases are not recorded.
 
“Some of those who are referred from Namutumba to Iganga, Bugiri or Jinja for further management die but it is very difficult to track their health or death records because they do not come back to our facilities,” Dr Kajubi said.
 
He added: “We cannot blame the midwives nor nurses, but the mothers who wait for labour pains and contractions to start and then rush to health centres when it is too late.”
 
According to Dr Kajubi, it is advisable for an expectant mother to start pushing the baby while in the right hands of midwives because during contraction, she becomes weak and many die of fatigue.
 
Dr Kajubi further faulted men for reportedly not playing their role by supporting and escorting their spouses for antenatal visits, which he said is “advisable”. “Instead, it is unfortunate that men are the ones taking their spouses to TBAs for delivery because they are cheap,” he said.
 
Ms Sarah Akello, a midwife at Namutumba Health Centre III, said the findings clearly show why mothers are dying while giving birth. “It is unfortunate that it takes two to be pregnant but men have left women to suffer alone,” she said.
 
Ms Rita Namaganda, a senior midwife at Nsinze Health Centre IV, said sometimes, expectant mothers come for delivery without a caretaker and mama kits, while others come on foot, not even on a boda boda.
 
“But life has to be saved first. It is very expensive to lose a mother, and it is very bad for a mother to enter a maternity ward expecting a baby and return home in a coffin,” said Ms Namaganda.
 
The Namutumba Resident District Commissioner (RDC), Mr Thomas Matende, confirmed that expectant mothers die while giving birth, but downplayed the issue being as a result of poor or impassable roads and lack of enough ambulances, but their alleged failure to go for antenatal services and visiting TBAs.
 
He said the district has two government ambulances, each in Bukono and Busiki constituency, and quickly conceded that they are not enough to handle emergencies.