A call to improve quality of care for pregnant women and new-borns

A recent UNFPA report stated that midwives could save up to 4.3 million lives a year by 2035 if they were to work at their full potential. Therefore, it is critical that midwives are highly skilled and facilitated to provide the highest possible quality of care for all women.

Secondly, Uganda still has a high maternal mortality rate. While the percentage of women who give birth at health facilities has risen to 74 percent, mothers continue to die from pregnancy-related complications in health facilities.

Institutional maternal and new-born deaths point to challenges in the quality of care that mothers and new-borns receive. Without improving the quality of care for mothers and their new-borns, it is highly unlikely that we shall meet Sustainable Development Goal (SDG) 3.1

The World Health Organisation has developed a quality-of-care vision for pregnant women and new-borns. I invite all Midwives, other health workers, government officials, and stakeholders to reflect on the key characteristics of high-quality care amidst our celebration of midwives.

•  Is it Safe?: Is the care we provide to mothers and new-borns safe? Does it minimize harm to users including minimizing preventable injuries and reducing medical errors?

•  Is it Effective?  Are we providing care based on scientific knowledge and evidence-based practice? This includes having an ecosystem that supports the recruitment and retention of highly skilled and knowledgeable health professionals as well as adherence to clinical guidelines and protocols.

•       Is it Timely? Are we providing timely care? Are we reducing delays in the providing and receiving of care? Are mechanisms in place for quick access to appropriate levels of care for mothers, including timely interventions (diagnosis, treatment, procedures) for mothers and new-borns?

•       Is it Efficient?: Are we delivering care in a manner that minimizes resources and reduces wastage?

•       Is it Equitable?  Are we providing care which does not vary in quality because of personal characteristics, geographical location, or socioeconomic status. Do we provide a different level of care to women of a higher socioeconomic status from that we provide pregnant women of lower socio-economic status? Are we all comfortable seeking the same care for ourselves or loved ones as that we provide?

•       Is our care people centred?  Are we providing respectful Maternity care? This calls us to deliver care which takes into account the needs of individuals, their culture and that of their communities. Are we respectful, kind, compassionate, ensuring privacy to the mothers and new-borns we care for?

If we carefully reflect on the above characteristics of high-quality care, we can easily identify where the gaps are in the care we provide for our mothers and new-borns. The Ministry of Health and partners have instituted mechanisms for such discussions to be held for example the weekly maternal and perinatal death surveillance and response reviews, continuous quality improvement projects, and more can be held at all health facilities to enable health workers improve the care they provide for mothers and new-borns.

I implore all of us – government, partners, communities, midwives, and all health workers to have honest discussions and to work collaboratively to fix the bottlenecks in the quality of care our mothers and new-borns receive. Without these discussions and tackling the challenges head on, we shall continue to see too many of our mothers walk into health facilities alive and ready to bring life into this world, only to not be able to walk out alive.

All players can do their part in ensuring that our mothers and new-borns have the highest quality of care at the time they need it by embracing the key quality of care characteristics as stipulated by the WHO.

Ms Irene Atuhairwe is the Country Director, Seed Global Health