The Eastern African Sub-regional Support Initiative for the Advancement of Women (EASSI)

Dire statistics in regard to maternal mortality galvanized EASSI to put in place a programme on Sexual Rights and Reproductive Health specifically looking at financing for this sector in two selected countries of Kenya and Uganda. UN MDG report 2008 reveals dismal performance on MDG 5 on maternal mortality, in the Sub-Saharan African region. A review of the progress in the implementation of the Beijing Platform for Action in 8 countries in the Eastern Africa region (EASSI 2005) revealed minimal progress in the area of women’s health especially maternal health. Uganda is among the countries that have had a persistent high maternal mortality rate. The poor maternal health outcomes are attributed to a number of factors including policy implementation, resource availability and service delivery challenges.

EASSI identified Women’s Reproductive Health and Sexual Rights as a priority area for the new strategic plan 2009 – 2013. EASSI believes that the budget of any government is the technical instrument by which commitments should translate into monetary terms to ensure effective implementation of the commitments and efficient service delivery. In addition, the budget reflects a government’s policy priorities. Whilst there have been  many efforts made by the Uganda government at policy level to meet the reproductive and sexual health international obligations and commitments in the areas of population and development, poor or inadequate service delivery, suggest that many gaps especially at the service provision level still exist. Specifically under the theme of Reproductive Health and Sexual Rights, EASSI’s strategic objective is to promote effective and transparent public resource mobilization, allocation, and utilization for reproductive health and sexual rights services and gender sensitive budgeting. In order to achieve this objective, it is important to ascertain government commitment to SRHR. Tracking investment in SRHR with particular focus on maternal health and safe motherhood was found necessary to inform EASSI’s advocacy interventions. The objective of policy, legal and institutional frameworks analysis is to ascertain the gaps especially at the service provision level.  The analysis provides analytical linkages between policies, legislation and institutional framework and gaps in reproductive and sexual health service delivery.

The Findings in Uganda:

§         Persistent Maternal Mortality over the years – currently estimated at 435/100,000 (2006)

§         6000 Women die every year.

Major Causes of Death

§         Hemorrhage – 26%

§         Sepsis – 22%

§         Obstructed Labor – 13%

§         Unsafe Abortion – 8 – 10%

§         Pre-eclamsia/Eclampsia – hypertension – 6%

§         Others (Malaria/HIV) – 25%

Maternal Morbidity

§         15% of all pregnancies develop life threatening complications

§         Post abortion complications – 23%

§         HIV/AIDS – 6.2%

§         Chronic Pelvic infection

§         Obstetric fistula

• Anaemia – 53%