By Mike Rwothomio

The Zombo District Health Office (DHO), in partnership with the Alur Kingdom, has initiated a community-based sensitization and dialogue programme aimed at increasing uptake of facility-based maternal and newborn care services across the district.

District Health Officer Dr. Mark Bramali revealed that approximately 40% of deliveries in Zombo are still conducted at home by unskilled birth attendants, significantly elevating the risk of obstetric complications such as postpartum haemorrhage (PPH), sepsis, obstructed labour, and neonatal mortality

“Home deliveries without skilled birth attendants remain a leading preventable cause of maternal and perinatal deaths in the district,” Dr. Bramali told Alur’s Prime Minister (Jadipu) during a high-level consultative meeting.

Dr. Bramali urged the Alur Kingdom to leverage its extensive grassroots structures and cultural authority to mobilise couples of reproductive age to utilise professional antenatal care (ANC), skilled birth attendance, and postnatal care (PNC) services available at government health facilities.

Community dialogues, recently launched at Warr Health Centre IV, are targeting high-burden chiefdoms including Juloka Jupa Jalubinyu, Pakwala Jupa Jalukongo, Omua Jupa Kago, and Jupa Thoi village in Warr Town Council.

Participants proposed the imposition of traditional fines on couples who opt for home delivery. While acknowledging the potential deterrent effect, both the District leadership and the Prime Minister emphasised that any punitive measures must be formalised through a District Council bylaw and gazetted before implementation. 

In one reported incident, Rwoth Jalubinyu had already collected a goat as a fine from a couple who delivered at home; he was directed to suspend such actions pending legal framework approval.

The initiative aligns with the Ministry of Health’s 2023–2025 strategic plan, which prioritises community mobilisation, emergency obstetric and newborn care (EmONC), and referral systems to reduce maternal and perinatal mortality by at least 30%.

According to the Uganda Demographic and Health Survey (UDHS) 2022, although institutional delivery rates have improved nationally, home births continue to contribute disproportionately to Uganda’s maternal mortality ratio (MMR), estimated at 336 deaths per 100,000 live births (2017–2022 reporting period).

Health authorities in Zombo stress that timely access to basic and comprehensive emergency obstetric care can avert nearly all maternal deaths attributable to the leading causes: haemorrhage, hypertensive disorders, sepsis, and unsafe abortion complications.

The joint programme will continue with expanded community barazas, radio talk shows, and engagement of village health teams (VHTs) to promote the full continuous sequence of maternal, newborn, and child health (MNCH) services.

Officials posed for a photo after a dialogue

Mike Rwothomio is news editor at zoomer Africa, your number one grassroot information hub