Researchers are investigating unexplained deaths of babies who are stillborn or die shortly after birth. The investigation follows a government review that found that nearly half of perinatal deaths recorded in Kasese District could not be explained.
Dr Richard Mugahi, the Commissioner for Reproductive and Child Health at the Ministry of Health, says an assessment of data from the country’s maternal and perinatal death reviews found that 48 percent of perinatal deaths in Kasese had no established cause.
Kyegegwa District also recorded a high proportion of unexplained deaths, with health workers unable to determine what caused about 20 percent of the deaths reviewed. Mugahi says establishing the cause of each death is critical because it enables the health system to identify specific problems and design interventions to prevent similar deaths.
The Ministry of Health, working with UNICEF and the Coalition for Health Promotion and Social Development (HEPS Uganda), has now launched an implementation study to improve how perinatal deaths are investigated and documented. The study will initially be conducted in Kasese, Kyegegwa and Mukono districts.
Mugahi says Kasese was selected because of its proximity to the Democratic Republic of Congo border, an area vulnerable to disease outbreaks and epidemics. Kyegegwa was selected because it hosts refugees, while Mukono was chosen because of its mix of urban and peri-urban communities.
The researchers will train health workers to collect more accurate and detailed information on deaths occurring both in health facilities and in communities. Kenneth Mwehonge, the Executive Director of HEPS Uganda, says the organisation will support surveillance and continuously monitor the quality of the data collected.
Mwehonge says the researchers were particularly concerned by findings showing that many of the babies whose deaths could not be explained had normal birth weights of 2.5 kilogrammes and above. He says the study could identify unexpected diseases or gaps in the health system that may be contributing to the deaths.
Mugahi says some unexplained deaths may also be linked to cultural practices that prevent health workers from examining stillborn babies. He says health workers in some districts have reported cases in which families take away stillborn babies before they can be examined because of beliefs that such deaths are a bad omen.
Mugahi says a proper examination can help determine whether a baby died during delivery because of delays or gaps in accessing care, or whether the death occurred earlier as a result of problems during pregnancy. He says the Ministry has already strengthened the documentation of maternal deaths occurring in communities, with Community Health Extension Workers required to investigate and record such cases.
The new study will establish whether a similar approach can be used to improve reporting and investigation of perinatal deaths in communities. Uganda recorded a perinatal death rate of 17.8 deaths per 1,000 births in 2023, according to figures from the Uganda Bureau of Statistics.
Researchers and health experts say the official figure may not capture the full scale of the problem if a significant proportion of perinatal deaths are not properly investigated or their causes remain unknown-URN. Give us feedback on this story through our email: kamwokyatimes@gmail.com
