Enabling and Expanding the Scope of Public Health Decision Making in Uganda to Reduce Maternal Mortality: Concept Note and Use Case


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Author(s): Kumar, M., Kim, T. E., Millar, E., Ongechi, K. S., & Weiss, W.

Year: 2019


Kumar, M., Kim, T. E., Millar, E., Ongechi, K. S., & Weiss, W. Enabling and Expanding the Scope of Public Health Decision Making in Uganda to Reduce Maternal Mortality: Concept Note and Use Case. Chapel Hill, NC, USA; MEASURE Evaluation, University of North Carolina.
Enabling and Expanding the Scope of Public Health Decision Making in Uganda to Reduce Maternal Mortality: Concept Note and Use Case Abstract:

In Uganda, the maternal mortality ratio (MMR) was 336 maternal deaths per 100,000 live births in the seven-year period preceding the 2016 Uganda Demographic and Health Survey (UDHS) (Uganda Bureau of Statistics [UBOS] & ICF, 2018). This is a notable decrease from the MMR of 438 maternal deaths per 100,000 live births in the seven-year period preceding the 2011 UDHS (UBOS & ICF International, 2012). Even so, the country’s MMR is still much higher than the target for 2030 set by Sustainable Development Goal (SDG) 3 (United Nations [UN], 2015): fewer than 70 maternal deaths per 100,000 live births globally, and around 111 for Uganda (UN, 2015). Much work needs to be done in Uganda to close this significant gap and achieve the SDG 3 there.

A major cause of maternal mortality is postpartum hemorrhage (PPH) (Partnership for Maternal, Newborn & Child Health, 2011). Deaths owing to hemorrhage at a facility could perhaps be attributed to a stockout of uterotonics or lack of a provider trained to give a uterotonic. Typically in the low- and middle -income countries, a health management information system (HMIS) does not provide data on stockouts and training of health staff, yet these are important data elements. Data on maternal complications and cause of maternal mortality are also vital but rarely collected. These are important for understanding what types of complications and causes of death are most common in a particular area, which is helpful when planning trainings and delivery of commodities. As can be seen, preventing maternal mortality involves many aspects of a health system, and thus data from the different elements are needed to inform programs and policies.

The PPH use case presented in this document shows that typically, policymakers and program managers make two types of decisions, and these are based on the sources of data they use for decision making.

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