Uganda like other countries record maternal related challenges from abortions, neonatal, infant and maternal mortality among others. Health care services during pregnancy and childbirth and after delivery are important for the survival and well-being of both the mother and the infant. Maternal health is a core dimension of the global health development agenda. Furthermore, the Government of Uganda has prioritized it in the national health agenda through the Roadmap for Accelerating the Reduction of Maternal and Neonatal Mortality and Morbidity in Uganda (2007-2015) and as a strategic and priority health care intervention area under the current Health Sector Development Plan (HSDP 2020/2025).
In Uganda, based on the 2016 statistics UDHS (2016), almost all women (97%) age 15-49 with a live birth in the past 5 years received antenatal care (ANC) from a skilled provider during their most recent pregnancy. However, only 29% of women had their first ANC visit during the first trimester of pregnancy. Sixty percent completed at least four ANC visits. In terms of services obtained during ANC, most women who attended ANC for their most recent pregnancy in the past 5 years had a blood sample taken (93%), were weighed (88%), and had their blood pressure measured (72%); they were less likely to have a urine sample taken (39%).
Eighty-one percent of the last live births in the past 5 years were protected against neonatal tetanus.More than 7 in 10 live births in the past 5 years were delivered in a health facility (73%) and with skilled birth attendance (74%). In relation to Postnatal care: For the most recent births in the past 2 years, only 54% of women and 56% of newborns received a postnatal check within 2 days of delivery.
Adult mortality: One hundred and forty-four per 1,000 women and 223 per 1,000 men age 15 would be expected to die before age 50. Lifetime risk of maternal death: At current fertility and mortality rates, 2% of women in Uganda will die from maternal causes. Maternal mortality ratio: The maternal mortality ratio for the 7-year period before the 2016 UDHS is estimated at 336 maternal deaths per 100,000 live births. Pregnancy-related mortality ratio: The pregnancy-related mortality (including deaths from accident or violence, comparable with previous UDHS surveys) ratio estimate for the 7-year period before the 2016 UDHS is estimated at 368 pregnancy-related deaths per 100,000 live births.
In relation to Family Planning(FP), scaling up FP services is one of the most cost-effective Interventions to prevent maternal, infant, and child deaths globally, contributing to the Sustainable Development Goals (SDGs). Through a reduction in the number of unintended pregnancies in the country, it is estimated that one-quarter to one-third of all maternal deaths could be prevented.
Family planning is linked indirectly as a contributor to positive health outcomes. For example, FP interventions contribute to reducing poverty increasing gender equity, preventing the spread of HIV, reducing unintended teenage pregnancies, and lowering infant deaths. Family Planning (FP) has Also been recognized by The National Planning Authority as one of The most cost-effective health and development interventions to achieve vision 2040.
The good news is there is strong policy and political commitment to support FP interventions in Uganda. The President of Uganda has made several financial commitments to support the reduction of unmet needs for FP. These commitments were made in 2012 at the London Summit on Family Planning, another at the Uganda National Family Planning Conference in July 2014, and in Nov. 2019 at the International Conference on Population and Development in Nairobi
UDHS (2016) Modern contraceptive use indicates that use of modern contraception among currently married women increased from 14% in 2000-01 to 35% in 2016. Injectable remain the most used method. In relation to Contraceptive discontinuation: In the 5 years preceding the survey, 45% of episodes of contraceptive use were discontinued within 12 months. The main reason for discontinuation was method-related health concerns or side effects (35%).
In relation to the demand for family planning: The total demand for family planning among currently married women increased from 54% in 2000-01 to 67% in 2016. Only 52% of demand is satisfied by modern methods. Unmet need for family planning was twenty-eight percent of currently married women and 32% of sexually active unmarried women. In terms of future use of FP services sixty-four percent of currently married women who are not using contraception intend to use a family planning method in the future.
The contraceptive prevalence rate (CPR) is 39% among currently married women age 15-49. Most currently married women using contraception use a modern method (35%). Among sexually active unmarried women, 51% use a contraceptive method and 47% use a modern method. Modern methods Include male and female sterilization, injectable, intrauterine devices (IUDs), contraceptive pills, implants, female and male condoms, the standard days method, the lactational amenorrhea method, and emergency contraception.
Personal Experience
As a young mother, the founder of PYM experienced constraints including balancing new motherhood with work, limited support system due to COVID travel restrictions that made it difficult to transport house helps, wounded nipples, limited breastmilk supply, strong backache, swollen feet, colic which was punctuated by discomfort, crying and sleepless nights, anxieties caused by delayed to fall off of the umbilical cord.
In as much as some sound obvious to an experienced mother these have resulted into immense depression and despair. Generally, the founder just like majority of first time mothers lacked skills in management of colic that her child was experiencing, how to breast feed without the infant or neonates biting the breast nipples, positioning/posture of a child during breast feeding, how to stimulate milk and ensure the baby has food to take, measures to address lack of breast milk amidst the demand from the child, how to involve the husband and other support systems to achieve a shared burden during child upbringing.
Aware of the own experiences, the global and Ugandan state of maternal and child health indicators the founder birthed the PYM to support mothers circumvent the hitherto constraints that the founder experienced but also the glaring issues in Uganda and global community in relation to the health of mothers, neonates and infants.
It’s against the afore discussed background that the formation of the Proudly Young Mothers(PYM) was conceived in 2020. The P.Y.M is a non-Government Organization that is intended support young mothers to navigate through the myriad of discussed challenges including, access to family planning, attendance to antenatal and post-natal services to ensure eradication or reduction of undesirable health outcomes such as maternal mortality, neonatal, infant, pre and post-natal depression especially among young mothers.
The PYM is a very impactful space for all mothers in general. It is a platform where mothers express themselves freely and walk a journey together in from preconception, conception, expectancy period, delivery, antenatal and post-natal, neonatal and infant nursing cares.
In as much as the PYM targets mostly first time mothers, it also helps the grownup mothers as it allows transition from young motherhood to grown up mothers creating a platform for sharing of experiences. There is no limit to motherhood inquiries, ideas and wisdom shared on PYM online platforms such as PYM WhatsApp group, PYM You tube Channel, and more.
It can’t be forgotten of seasons where those that have just birthed nurse postnatal depression, growing baby brains, struggles of balancing the new role of motherhood with work, career, ministry responsibilities, communal responsibilities, home management, adjustment to bedroom fitness and preparing mentally for sexual intercourse with their partners, hygiene management, breast milk supply and its challenges, dealing with shedding off baby weight among other aspects.
The founder’s heart still beats for the young mothers who are still in school, villages, those that ran away from home because of unavoidable circumstances afore mentioned.
Question is; how do these young clueless mothers maneuver through life after birth with all the scarcity challenges? PYM is the ultimate solution to such and more