Growing slowly and steady

BMMC: A centre for quality health service delivery

By Pamela Daisy Miremba
Bishop Masereka Medical Centre (BMMC) is located in Kasese municipality, in the western part of Uganda, bordering with the Democratic Republic of Congo. The medical centre was started in 2004 with a variety of health services and standards to the entire community. As need raised in relation to the Kasese municipality high fertility rate of 7.3 percent, which is above the national average of 6.7 percent (UDHS 2006), and the infant mortality, the medical centre decided to improve on service delivery by setting up an operating theater in 2009, in order to save the lives of pregnant mothers and their newly born babies. The medical centre has a full time staff of nine, including a nursing manager, a medical officer and two clinical officers.

Bishop Masereka Medical Centre is now focusing on promotion of maternal and child health. While improvements in service delivery are expected in the future, challenges still disrupt the services. The major challenge is lack of adequate space for nursing the mothers, the newly born babies and the under-5s. The maternity ward has a capacity of only three beds, which is very small compared to the number of mothers seeking services. The number has drastically increased from 35 percent to 63 percent from 2008 to date. With the desire to solve this problem, the management has decided to construct a better and adequate ward for the mothers and their children. The challenge is that funds seem to make the construction sluggish.

Another challenge is that the number of mothers delivering from home seems to be on the increase from five percent to 12 percent, from 2010 to date. These are screened out during community outreaches, immunization sessions and a few report to the health unit with complications such as septicemia and neonatal tetanus, which currently accounts for 47 percent, from October 2009 to date, while the mothers who come with puerperal psychosis, postpartum hemorrhage, and puerperal septicemia indicates 20 percent.

It has been observed that the number of mothers infected is on the rise by 20 percent from 2008 to date compared to 16 percent between 2006 and 2008. The number of antenatal attendance has drastically increased from 48 percent to 76 percent per month from 2005 to date. The number of those bringing children for immunization has increased from 30 percent to 75 percent from 2008 to date. Home visiting is basically done for those at risk, on weekly basis. However, the challenge is that transport to reach them may not be available at the scheduled time since the organization has one vehicle for all the services done. This leaves a gap in fulfilling the planned activities. An incubator is available for the premature babies and its use indicates great improvement in the care for neonates. The challenge is that space to fix a good number of incubators if availed is not adequate.

The referral system has also been improved by buying an ambulance, which is always stationed at the hospital 24hours. It is meant to transport mothers with complications beyond our services to where they can get further management, and pick those who have developed complications elsewhere when called for.

With a strong and committed team of staff, Bishop Masereka Medical Centre is growing slowly and steady, but sure of quality service delivery in order to promote maternal and child health. An obstetrician can be maintained at $2,500 per month. This includes salary, transport, house rent and allowances. This one mainly works as consultant on maternal and child health emergences. The midwives, each could be maintained at $500 per month, this also includes salary, transport, house rent and allowances. The midwives carry out antenatal, intranatal and postnatal activities. Home services also are headed by the midwives. A radiographer helps in detecting any abnormalities during and after pregnancy. This one can be maintained at $800. Finally, a community counselor who provides spiritual and psychological support as part of the team can be maintained at around $300.