A stitch in time saves nine: LWF upholds maternal health in Kyangwali refugee settlement

14-year-old Shifra Makombi attends to her baby in Kyangwali refugee settlement. She delivered her baby at Kituti Health Centre III with the help of Midwives working with LWF.


Kyangwali refugee settlement - It’s 3:30 pm here in Kyangwali refugee settlement. 14-year-old Shifra Makombi (not real name) is experiencing labor pains. The 14-year-old rape survivor is rushed to Maratatu Health Centre II where she can hardly get the special medical attention she deserves.

Sumaya Nakamatte a midwife assesses Makombi’s situation and notices that it’s a high risk pregnancy since her pelvis is small and not fit for natural birth. This, the midwife attributes to Makombi’s young age and early pregnancy.

Nakamatte wastes no time to recommend a referral for the teenage mother to Kituti Health Centre III which is a bigger facility with better equipment and services.

Unlike in many rural areas, an ambulance is readily available to rush Makombi to Kituti Health Centre III where she is accompanied by Midwife Nakamatte.  


A midwife working with LWF immunizes a pregnant woman against tetanus in Kyangwali refugee settlement.


As soon as the ambulance arrives at Kituti, Makombi is rushed to the maternity ward where she surprisingly undergoes a normal delivery with the help of two midwives stationed at the health facility and work with the Lutheran World Federation (LWF) with funds from the United Nations Population Fund (UNFPA).  At 6:55pm, Makombi welcomes her happy and healthy baby boy to the world. 

Makombi is fortunate enough to receive well-timed health care, thus saving both her life and the baby’s. However, according to the 2016 Uganda Demographic Health Survey, 368 out of 1,000 mothers in Uganda, especially in rural and isolated areas die while giving life, others experience adverse effects. This is largely blamed on the lack of access to or delayed health services.

“If Makombi hadn’t reported to the health facility early enough, she would risk experiencing obstructed labor, fistula, hemorrhage as well as fetal and maternal distress.” Says Midwife Nakamatte.


LWF and MTI staff conducting an outreach on Sexual Reproductive Health in Kyangwali refugee settlement.


In Kyangwali refugee settlement, tens of lives are lost every year to maternal health emergencies mainly due to lack of and delayed access to professional health services.“Majority of the women prefer using local herbs for antenatal care and birthing their children from home with the help of traditional birth attendants because it’s cheaper.” Says Nakamatte. 

“The health facilities are quite far, which makes it hard for us to access them while we leave the rest of the children home alone.” Explains Michelle, a mother of three in Maratatu B, Kyangwali settlement.

Delay has been known to be a major cause in the state of maternal mortality in Uganda. The 3 delays (3Ds) including; Delay to make the decision to seek care, Delay to reach the health Centre and Delay to receive the appropriate care once at the health facility.


A midwife attends to a pregnant woman. Through the Promoting Effective and Responsive Health Systems to Maternal Health project funded UNFPA and implemented by LWF in Kyangwali refugee settlement, pregnant women are urged to receive antenatal and postnatal care. Photo credit: Flash Media Uganda.


To counter and mitigate the effects of the 3 delays, LWF with funds from UNFPA recruited two midwives to extend their services towards child delivery, antenatal and postnatal care for pregnant women; offered two ambulances to assist in referrals for emergency obstetric care; supports pregnancy mapping to locate and follow up pregnant mothers to ensure that they receive antenatal care and to also increase deliveries at health facilities.  

Through the Promoting Effective and Responsive Health Systems to Maternal Health project funded UNFPA in Kyangwali refugee settlement, 352 mothers have received professional health services while delivering their babies at Kituti Health Centre III, 1, 362 women have received antenatal care, over 2,500 pregnant women have been mapped to ensure that they receive antenatal care and deliver their babies from health facilities.  

With funds from the United Nations Population Fund (UNFPA), LWF implements humanitarian activities aimed at extending health services to pregnant women, preventing as well as mitigating effects of maternal and neonatal deaths in Kyangwali refugee settlement.