By Moses Sserwanga
Ruth Nabwire (not her real name), aged 17, is one
of many young mothers whose preterm baby was admitted to the remodeled Neonatal
Intensive Care Unit (NICU) at Kawempe Government Referral Hospital in Uganda’s
capital, Kampala as of 4th November 2025.
Every four hours, she joins other mothers in the
congested NICU to breastfeed and care for their preterm babies under close
supervision by hospital staff. The young mother was particularly glad about the
NICU’s modern equipment; without it her preterm baby, delivered three weeks ago
and weighing slightly more than 1.2kg, would likely have died.
“I'm happy to be here because the caring medical
staff have assured me that my baby girl will survive, and I will be discharged
in two weeks. I was admitted with infections to the High Dependency Unit (HDU),
and the doctors and nurses determined that I needed surgery and that my preterm
baby had to be moved to the NICU, where she is now under specialized care and
observation. The doctors allow us in to breastfeed and care for our babies,”
Nabwire explained, smiling.
According to the hospital’s Executive Director, Dr
Emmanuel Byaruhanga Kayongoza, Kawempe Government Referral Hospital (KGRH) is a
200-bed facility and one of the busiest maternity units in Africa. This
translates to an immense workload for the hospital staff and associated
resources. The hospital handles thousands of deliveries – at least 21,000 – and
other emergency obstetric cases annually. On average, the hospital receives 80
expectant mothers, and 100 babies are delivered each day.
This reflects the significantly disproportionate
burden of maternal and newborn mortality, with Kawempe National Referral
Hospital contributing about 60 per cent of institutional maternal and perinatal
mortality in the Kampala Metropolitan Area (Kampala, Wakiso, Mukono and Mpigi
districts). Kampala currently records an institutional mortality rate of 222.8
per 100,000, the highest in Uganda compared with other regions. The national
average stands at 38.8 deaths per 1,000 births, which is double the national
average of earlier years which stood at 18.5 per 1,000 births.
For Dr Loy B. Nabirye, a neonatologist and
pediatrician at Kawempe National Referral Hospital, says it is a busy routine
managing a high rate of teenage pregnancies and related complications. On
average, the hospital receives about 150 teenage pregnancies per week. This
reflects the teenage pregnancy rate, which stood at 28 per cent for 2024–2025.
“The numbers can be overwhelming given the limited
facilities and resources available. We are very grateful to the Government of
Sweden, which, through the United Nations Children’s Fund (UNICEF Uganda),
generously funded the remodeling and reorganization of service delivery at the
HDU and NICU to manage severe obstetric cases,” Nabirye stated.
Nabirye revealed that since 2019, the strong
partnership with the Swedish Government through UNICEF has significantly
contributed to improvements in the quality-of-service delivery, ensuring better
health outcomes for both mothers and their babies.
“UNICEF has supported us to provide essential
newborn equipment including mechanical ventilators, patient monitors, CPAP
machines, radiant warmers, transcutaneous bilirubinometers, 10 baby incubators,
infusion pumps and wall oxygen extension and baby cots, among others,” Nabirye
said.
Some of this equipment has also been provided at
Bwera General and Fort Portal Referral hospitals with the same support from
Sweden through UNICEF.
To follow up on this important Official Development
Assistance (ODA) from the Swedish Government, in fulfilment of the rights
of the most vulnerable in the least developed countries, including children, a
delegation of eight Swedish Members of Parliament and staff from UNICEF Sweden
undertook a field visit to Uganda.
The MPs represented eight political parties in
Sweden and included Katrina Tolgfors, Martina Johansson, Magnus Berntsson,
Yasmine Eriksson, Joar Forsell, Janine Alm Ericson, Markus Kauppinen and
Andreas Lennkvist Manriquez. They were accompanied by two staff members from
UNICEF Sweden, Karin Strömstedt and Erik Windmar.
They were joined in Kampala by the UNICEF
Representative to Uganda, Dr Robin Nandy; Dr Yaron Wolman, Chief of Child
Survival and Development at UNICEF Uganda; and Adam Kahsai Rudebeck, the
Counsellor, Deputy Head of Mission and Head of Cooperation at the Embassy of
Sweden. During the visit, the Swedish MPs were warmly welcomed at
UNICEF-supported facilities including Kawempe National Referral Hospital in
Kampala, Bwera General Hospital in Kasese, Kamwenge (refugee-hosting) District,
and Fort Portal Regional Referral Hospital in Kabarole District.
At Kawempe National Referral Hospital, Dr Nabirye
told the visiting MPs that the facility turnover is around 650 neonates per
month, meaning the hospital manages between 80 to 130 neonates daily, of which
about 60 per cent are premature with low birth weight (LBW) between 0.5kg
and 2.49kg. Following UNICEF support, the hospital has established a high
care unit (HCU) to manage preterm babies, a high care term unit, an
intermediate care unit, and a Kangaroo Mother Care Unit (KMC), achieving a survival
rate of 83 per cent for preterm babies.
In Kasese, the Chief Administrative Officer, Mr
Paul Walakila, told the Swedish MPs that the district is a hotspot for
epidemic-prone diseases and meteorological disasters influenced by geography,
climate and mobility across its porous border with the Democratic Republic of
Congo (DRC). Outbreaks of Ebola, cholera and measles have occurred, while
malaria and HIV remain major endemic health burdens.
Walakila noted that despite these challenges, with
Sweden’s support through UNICEF, the district has procured a specialized NICU
and basic maternal and newborn resuscitation equipment at Bwera Hospital. “We
have also trained Village Health Teams (VHTs) and implemented robust integrated
community outreach to address teenage pregnancies and gender-based violence,”
he said, citing a 24-year-old grandmother whose 12-year-old daughter gave birth
in Mukunyu Sub-County. He thanked the Swedish Government for enabling
health reporting systems and interventions to raise community awareness about
child pregnancies, gender-based violence, child abandonment and child labour,
among other issues.
With support from UNICEF, the district has trained
over 1,000 model parents and 5,930 adolescents in child protection, sexual and
reproductive health, and life skills. Due to limited access to immunization
services and harder-to-reach populations, Kasese District organizes four
outreach sessions per month to provide immunization, antenatal care, nutrition
education and growth monitoring for children under five. Outreach sessions are
conducted jointly by health workers and VHTs, with support from the Ugandan
government and development partners, including UNICEF.
The Swedish MPs visited households in Mpondwe Town
Council and interacted with model parents and VHTs to understand
community mobilization and the para-social services they offer in their
areas of operation. In Nyabugando Ward, Ms Monica Masika, a para-social worker,
was seen conducting one of the weekly VHT community health outreaches where
mothers gather and are trained on preparing nutritious meals for their
children, ensuring immunization and reporting cases of child abuse,
neglect and gender-based violence.
The nursing officer in charge of the neonatal ward
at Bwera General Hospital, Ms Doreen Mbabazi, guided the MPs on a tour of the
newly constructed NICU, which has improved the treatment of children. The MPs
spoke with two mothers who gave birth to preterm babies weighing 0.4 kg and 0.6
kg. Thanks to the modern equipment installed at the facility, the babies were
well managed, gained weight and were discharged.
At Fort Portal Regional Referral Hospital, the MPs
visited the In-Patient Therapeutic Centre (ITC), where severely malnourished
children are treated and parents trained on balanced diets. Wilson Bwambale, a
father of twin boys, was at the ITC receiving care for his two-year-old
malnourished sons. He expressed gratitude to the MPs for the visit and for
Sweden’s support in strengthening Uganda’s health systems. On-the-job
mentorship and coaching for facility staff in maternal, infant, young child and
adolescent nutrition (MIYCAN), Integrated Management of Acute Malnutrition
(IMAM) and Baby-Friendly Health Facility Initiatives (BFHI) are provided at the
hospital.
Dr Archbald Newton Bahizi Sebahire, Senior
Executive Consultant at Fort Portal Regional Referral Hospital, noted that the
regional infant mortality rate is 46 deaths per 1,000 live births, higher than
the national average of 34 deaths. He also noted that adolescent childbearing
(ages 10–19) stands at 7.2 per cent, higher than the national average of 6.5
per cent.
Dr Bahizi said the hospital plans to construct and
equip a maternal-children ward complex to address infrastructure limitations
and deliver patient-centred care, improving health outcomes for mothers and
children. Dr Daniel Murokora, a Reproductive Health Advisor at the Ugandan
Ministry of Health, told the Swedish delegation that UNICEF has also provided
critical support to the Ugandan government during epidemic outbreaks such as
Ebola, mpox, and Covid-19.
“We have deployed these resources in a transparent
manner by establishing Water, Sanitation and Hygiene (WASH) infrastructure
interventions. These interventions have helped to stem the spread of deadly
diseases in Uganda and beyond,” he stated.
Scaling up and sustainability
Uganda’s Director General of Health Services, Dr
Charles Olaro, thanked the Swedish Government for the continued support through
UNICEF, which has helped to bridge gaps in emergency preparedness and set the
stage for scaling up and ensuring sustainability in the long term.
“The UNICEF support has catalyzed reforms in
surveillance, digital health and regulatory systems, and we are truly grateful.
There has also been increased capacity building. We have trained managers in
leadership skills and healthcare professionals in neonatal care. This has
strengthened hospitals’ ability to provide sustainable, high-quality care,”
Olaro told the Swedish delegation.
Dr Olaro said that for all the hospitals where
UNICEF has offered support, the Government of Uganda will establish expanded,
dedicated facilities for antenatal and neonatal care. Already, Kawempe National
Referral Hospital has established a separate centre for pregnant teenagers to
shield them from victimization and stigma.
The UNICEF Country Representative, Dr Robin Nandy,
urged health providers to take advantage of the support offered by the Swedish
Government to scale up services and to put plans in place to ensure
sustainability in the long term.
Swedish Members of Parliament speak out
The Swedish MPs expressed satisfaction with the
services being delivered as a direct result of Official Development Assistance
extended to Uganda by the Government of Sweden.
“We are delighted to learn and see that with
support from Sweden, the Government of Uganda is able to offer these critical
health services to the citizens of Uganda, especially mothers and children. We
will encourage ongoing dialogue between our two governments to ensure that
support continues and is directed to the identified priority areas,” Katarina
Tolgfors stated.
Janine Alm Ericson and Martina Johansson called for
the scaling-up of interventions to cover as many Ugandans as possible. Magnus
Berntsson and Joar Forsell expressed appreciation for the specialized care
extended to child mothers to deal with post-birth stress, and the training
extended to them to look after their newborn babies.
Email;msserwanga@gmail.com
All Photos by Zahara Abdul
