By Robert Atiku
 
More than one thousand expectant mothers in Maracha District failed to attend their first Antenatal Clinic (ANC) services in the last financial year.
 
This is contained in a recent HIV/AIDS stakeholders review meeting at the district.
 
Godfrey Odama, the district biostatistician says the antenatal attendance coverage for the ended financial year 2020/2021 is worrying.
 
"In terms of antenatal coverage, 88 percent of the expectant mothers in the previous financial year turned up for their first antenatal clinics. That is 9,547 of the expectant mothers, only 8,394 came for first antenatal clinic (ANC) visit. We are saying there are some mothers who are pregnant but they don't want to come to the facility. And also in relation to HIV, what that statistics means is that 12 percent of those mothers didn't know their HIV status because they didn't come to the facility for testing”, he says.
 
Adding: “It is very important for expectant mothers to attend antenatal clinic services so that health workers can offer them necessary medical support. All these people should know their HIV status. So if the 12 percent are not coming, that means there may be infection. So in case out of the more than 1000 women, there are some HIV positives, there will a big chance that they deliver babies who will also be HIV positive. That is why we emphaise that atleast 100 percent of the expectant mothers should be able to antenatal clinics”.
 
There is however divided opinion as to why some pregnant mothers still fail to attend antenatal clinic services as required.
 
According to Godfrey Osutre, the LC3 Chairperson Sub county Paranga, some women have allegedly been harassed by some midwives, making them to shun antenatal services.
 
"May be due to frustration or other reasons, some midwives don't handle our mothers well. Midwives are among the people who are called to be lenient with humanity but some are not portraying this. They should be friendly to our women instead of abusing them”, Osutre said.
 
However, some midwives have also reported that some mothers are too relaxed to attend antenatal clinic services in their first three months of pregnancy but only report in the second trimester.

 
Recommendations
 
In 2019, ministry of health issued new guidelines requiring expectant mothers to make eight antenatal visits during the course of their pregnancy, as opposed to the previous four visits.
 
According to the Health Ministry, the number of antenatal visits has been increased to scale down the occurrence of still births and other pregnancy related complication such as pre-eclampsia, due to limited interactions between health workers and pregnant women.
 
The decision to by Uganda to shift to eight antenatal visits follows recommendations by the WHO in 2016. According to WHO, the move is aimed at increasing the access of expectant mothers to health care providers.

Data from Uganda Demographics and Health Survey shows that the number of expectant mothers who visit health centers for the first time for antenatal is higher than those who go for the fourth visit. The data shows that 97 percent of pregnant women attend at least one antenatal clinic during their pregnancy while only 60 percent visit a health facility a minimum of four times.
 

The plight
 
However a number of factors including socioeconomic status, place of residence and education level affect a woman’s likelihood of attending ANC, contributing to enormous disparities in access and utilization.
The quality of care during an antenatal visit is also important. Particularly in low-resource settings, shortages in essential medicines, equipment and trained staff are barriers to providing high quality care. In addition, the content of care delivered during pregnancy is poorly measured in some facilities, limiting the ability to identify and address weaknesses.


COVER PHOTO: Expectant mothers attending a maternal health education at Maracha Health Center IV. Photo by Robert Atiku