Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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Integrating HIV and health activism in Uganda


Leonard Okello with coalition members (c) Michele Sibiloni

In Uganda 16 women die giving birth every day and each year more than 25,000 babies are born with HIV. Understandably, maternal health is an issue many Ugandans feel very strongly about.

“The problem of maternal health is not an isolated issue. It demonstrates the crisis of governance in the health sector in Uganda. It is a symptom of the overall collapse of the health infrastructure in the country,” says Leonard Okello, Alliance Uganda Country Director.

The shocking state of maternal health in the country has motivated many civil society organisations to campaign together for better health services.

Addressing the causes of maternal mortality

The Ugandan Coalition to Stop Maternal Mortality was formed just over a year ago. It consists of 42 member organisations and has been led and developed by Alliance Uganda together with a wide range of civil society partners.  “We wanted to address the catastrophic situation of the entire health system in Uganda, but we knew our entry point had to be maternal health, everybody relates to a mother and her baby”, says Leonard.

The campaign has combined a wide range of strategies. This has included strategic litigation such as Petition 16, which argued that by not providing essential medical services to pregnant women, the government was violating their rights. It has also included grass roots mobilisation to lobby local-level authorities.

Asia Russell, from Health GAP (Global Access Project), commented that “Civil society campaigning and constant media attention has turned a scandalous situation that went unnoticed into a burning issue that the government can no longer brush aside.”

Leonard went on to say “For the first time in the history of this country the ordinary Ugandan is getting interested and concerned in the quality of health services so healthcare providers are becoming more accountable.”

HIV and the right to health

Alliance Uganda has provided leadership for the campaign and communications training. It has also channelled funding from a UKAID project to community based organisations that work to facilitate prevention of mother to child transmission (PMTCT) services, and to improve referrals from communities to clinics and hospitals.

The project has increased numbers of community referrals to maternal health services and antenatal care. It has also increased the number of deliveries attended by personnel with PMTCT and other birth delivery skills in several districts of Uganda.

The UKAID funded project has helped to link up many other health issues. The campaign has been a tool that has enabled Alliance Uganda and its partners to engage with authorities on other more difficult issues, such as the adequate provision of HIV services, not just for mothers and their children, but for all, including sexual minorities and other populations at higher risk of HIV.

Asia Russell commented “Alliance Uganda has been instrumental in enlarging the Maternal Health Campaign to include HIV activists and in demonstrating that untreated HIV is responsible for up to 25% of all preventable maternal deaths in Uganda. The Alliance has also provided important guidance to the coalition, allowing it to connect its work to the fundamental violation of rights that comes when communities do not receive life saving services, whether this means pregnant mothers and children or sex workers and gay men.”

Making an impact

In its first year the campaign has seen a lot of progress but the work is not over:

  • The 2011/12 budget contained a commitment by the Ugandan government to provide all pregnant women with free ‘mama kits’ (which contain blankets, cotton wool, razors, and other basic products) in hospitals. This had an immediate impact on the numbers of women turning up to deliver their babies in hospital. The coalition now aims to ensure adequate and sustained supply and appropriate distribution of the kits.  
  • Additionally, national budget allocation for maternal and child health included an additional 24 billion Ugandan shillings. Activists have worked to ensure these funds prioritised the increased recruitment of front line health workers, particularly nurses and midwives.   
  • As a result of public outrage and support for Petition 16 the government has instructed all districts to report and audit every maternal death in the health facilities.

As the campaign moves forward it will continue to fight for the rights of women and their children and address the broader needs of people at higher risk of HIV in Uganda.

You can read more in this blog post: Community campaigning for maternal health in Uganda