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Unmet obstetric needs amongst internally displaced populations in northern Uganda

Unmet obstetric needs amongst internally displaced populations in northern Uganda

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Published by Unicef Innocenti
Dr Christopher Garimoi Orach, Makerere University, discusses the unmet needs of new and expectant mothers among the displaced populations in Uganda. His findings were published as part of the 3rd edition of Research Watch on our website www.unicef-irc.org
Dr Christopher Garimoi Orach, Makerere University, discusses the unmet needs of new and expectant mothers among the displaced populations in Uganda. His findings were published as part of the 3rd edition of Research Watch on our website www.unicef-irc.org

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Published by: Unicef Innocenti on Feb 01, 2012
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02/01/2012

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UNICEFInnocenti Research Centre
Research Watch – Health and Equity (No. 3/2012)
Unmet obstetric needsamongst internally displacedpopulations in northernUganda, 2007-2009
Dr Christopher Garimoi OrachMakerere University, School of Public Health
 
Introduction 
 
During two decades, 1986-2009, of civil war between the rebel Lord’s Resistance Army and Uganda governmentforces, an estimated 1.6 million people were displaced into encampment - internally displaced persons (IDPs)camps in northern and eastern Uganda. The districts in the Acholi sub-region bore the brunt of the war. The vastmajority 95% or 678,000 inhabitants of the districts of Pader and Kitgum districts were displaced. A total of 67internally displaced persons camps were established in the two districts.Worldwide, there are an estimated 15.6 million internally displaced persons and 10.4 million refugees. The vastmajority of the displaced populations live in Asia 4.3 million and 2.6 million in Africa (UNHCR 2010). The health ofdisplaced populations is affected by several underlying factors including insecurity, socio-economic and healthsystems. Although all displaced persons are vulnerable, women and children are the most vulnerable owing to avariety of socio-economic, cultural, gender and physiological/biological factors. We carried out a study to assessthe extent to which the obstetric needs of the populations in Kitgum and Pader districts in northern Uganda weremet during the period 2007-2009.
Methods 
 We collected data retrospectively from Kitgum and Pader districts in northern Uganda during February – March2010. Data were collected, from three hospitals namely Kitgum, St Joseph and Kalongo covering the period2007-2009. The data were collected on major obstetric interventions (MOI) which include caesarean section,hysterectormy and laporatomy for absolute maternal indication (AMI) undertaken in the three hospitals. Majorobstetric interventions performed for absolute maternal indications (AMI) are critical to saving the lives of both themother and baby (UON 2011). The data were captured and analysed using Microsoft Excel and SPSS softwarepackages respectively.
Findings 
A total of 1157 mothers, 527 (45.5%) in Kitgum and 630 54.5% in Pader districts had major obstetricalinterventions for absolute maternal indications respectively. The commonest major obstetric interventions forabsolute maternal indications were caesarean sections (99.4%) and hysterectomy 0.6% in both districts. Theoverall deficits in MOI for AMI in Kitgum was (82.6%) 2057 and in Pader (82%) 2667 respectively. In both Kitgumand Pader districts combined, deficits in MOI for AMI performed in urban was (45.1%) 209 versus (85%) 4,438 inrural setting. The main factors contributing to unmet obstetrical needs were lack of qualified health personnel andequipment, and long distance to health facilities.
Discussions 
 The study has shown huge unmet obstetric needs amongst the internally displaced populations in the two ruralwar torn districts of Kitgum and Pader in northern Uganda. Our findings corroborate the high morbidity and crudemortality rates (MoH 2005) and high maternal mortality ratios estimated at 526 in Kitgum and 700 per 100, 000live births in Pader districts respectively (MoLG 2008) which far exceed the national maternal mortality ratio of435 per 100, 000 live births (MoH 2011). Previous studies in West Nile districts of Uganda showed that refugeeshad higher met obstetric needs compared to the host populations (Orach and Debrouwere 2004). The findings

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