Want to be partners for life, then fill the gaps!

“You are paid using our taxes from the garden and you also want me to buy a book” said a mother to a midwife who had asked her to buy a book were her medical information will be written since the health center had run out of stationery. This is one incident of disrespect to midwives that I have seen at a health facility in Lira among others, and this happens because of the gaps in the health system which affects the partnership between mothers and midwives. This mother’s response to the midwife left me dumbfounded but am certain it left the midwife very angry and I could have affected her attitude to all the other mothers seeking care.

The World Health Organisation states that every woman has the right to the highest attainable standard of health, including the right to dignified, respectful care during pregnancy and child birth but how do we attain this if the there is no relationship. Women who go to facilities for care may encounter disrespect in different ways but these problems are systemic and persist may be because; some providers lack awareness about patients rights, some are stressed and overworked because they are under staffed. This doesn’t necessarily mean it is okay for the disrespect to continue because of the above reasons, but how about we start with getting solutions like solutions like; increasing health worker force, updated and improved training , and with a good work environment. Mid wives will surely then provide respective, sensitive and effective maternity services to mothers.

As the world commemorates the International Day of the Midwife today, with the theme, ‘Midwives, Mothers and Families: Partners for Life!’, am thinking beyond partnership. I believe in partnership and this is by far one of the best partnerships, but with the continuous shortage of midwives in Uganda and other countries, who will mothers have this partnership with? How much time and attention is a midwife able to give to mothers if she is able to work? Midwives in most developing countries are overwhelmed but continue to serve because they want to see every mother happy as they bring new life to the world.

Midwives everywhere understand that working in partnership with women and their families, they can support them to make better decisions about what they need to have a safe and fulfilling birth. Shortage of midwives is not just the only problem and it is important to note that there is need to not only recruit and retain midwives but also fulfilling the needs of the health system. If needs like water, electricity, delivery kits, well equipped labor suites are not there, this greatly affects their attitude and might later affect the relationship or partnership we thought a midwife should be having with a mother.

I was excited when I got to know this year’s theme was on partnership because for last year’s International day of the midwife, I wrote about Pregnant woman – qualified midwife: The best partnership to reduce maternal deaths.

To all midwives thank you, ‘apwoyo atek’, ‘mwebale nyo’, yalama noi …….!!!!

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Trillions of shillings could be lost annually to Malnutrition

So Uganda loses 1.8 trillion annually to stunting yet we need more investments in health, education among others. Even though less attention has been given to it, malnutrition has adverse effects on both children and adults but worse with children as it greatly affects their growth and development. Malnutrition not only impacts growth in the short term, but can also limit total bone growth and compromises a child’s immune system. Additionally, children classified as low height-for-age (stunted) may never be able to regain lost growth potential if they continue to live in a nutritionally deprived situation.

Malnutrition negatively affects brain development causing delays in motor and cognitive development, such as: attention deficit disorder, impaired school performance, memory deficiency, reduced social skills, reduced language development and reduced problem-solving abilities.
We want children to survive and thrive but this may not happen if we cannon invest in Early Child Development, specifically nutrition in the first five years. Do we want to see more children classified as low height-for-age (stunted) yet they may never be able to regain lost growth potential if they continue to live in a nutritionally deprived situation.

With the recently launched National Intergrated Early Childhood Development Policy of Uganda am hopeful that the Government of Uganda shall ensure that all households are food secure and have proper nutrition for proper child growth and development. This should involve supporting nutritious food production, nutrition care within the household, and Community mobilization to promote the adoption of healthy nutrition behaviors and increased public awareness of the centrality of improved nutrition to community and national development.
This reduce prevalence of malnutrition among infants and young children, expectant and lactating mothers. We shall then have more children survive, thrive and develop and thus save trillions of shillings.

Without Citizen engagement, the world may never achieve the lasting change it desires

“When they want to be elected leaders, they are beggars and when we give them the power it is sad that we the citizens become beggars. It is like they are doing us a favour to deliver services that they had committed to deliver” says Philomena a citizen from Uganda. The biggest cry the citizens have is that they want to see their respective leaders and other stakeholders commit to deliver. If the citizens are becoming beggars for services they need, then their rights are being abused, so how do the citizens hold different stake holders accountable? How do they get involved?
Dingaan Mithi, a citizen from Malawi, believes that the citizens are able to hold stakeholders accountable but they need to be empowered. Citizens can be empowered in different ways but the best is empowering with information. Most don’t have the information, not aware of their rights and don’t even know they have a say. It is time citizens are informed that provision of health care, education and other services is not a favor their governments is doing them but have a right to these services that should be to an accepted standard. Citizen participation is not only democratic but the most practical way to achieve lasting change the world desires to have by 2030.
From the citizen hearings in India organized by White Ribbon Alliance, Santana Murmu and Sujoy Roy appreciate in citizen engagement is productive and wise investment. It is the best way to listen and understand the citizens’ needs and how to get the solutions from them. Citizen engagement not only in in planning and implementing but also accountability will surely lead as to achieving the sustainable development goals. This is because it creates a good feedback mechanism between government, leaders and the citizens. Leaders hear from citizens, they get to know what they want and how they are able to achieve it.
Citizens are not asking for much, they want transparency, inclusiveness, deliberation and responsiveness. Nothing about them without them.

Philomena Okello stressing the need for citizen led accountability in the Sustainable development goals.