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Uganda: The Neonatal Intensive Care Unit (NICU) at Rwamwanja Health Centre saves babies

  • The Neonatal Intensive Care Unit (NICU) at Rwamwanja Health Centre III saves babies

Chantal Uwimana, a Congolese National is joyful her 3 months’ son old is alive. The baby was delivered preterm at 7 months with 1.6 kgs. The baby was put in the incubator at the Rwamwanja New-born Intensive Care Unit (NICU) where new premature born babies and critically ill are placed for specialised care and management.

Chantal who is all praises for the nurses at the NICU was discharged after 2 months to take care of her baby at home after the baby gained the acceptable weight of 2.8 kgs. She says had it not been the nurses at the NICU who cancelled her and assured her that her baby would survive, I almost died of pressure, Chantal recounts.

Chantal’s story is not different for Kakuru Jacqueline, a Congolese national too living in Rwamwanja refugee settlement. Jacqueline developed malaria at 8 months and delivered her 2nd born prematurely at 8 months. The baby was 1 kg at birth. The baby was immediately placed in the new-born intensive care unit for care. After 2 weeks, she was discharged after her baby gained 2kgs. The baby is 7 months now.

For Atuhaire Sharon’s miracle baby, Baby Elly was delivered on the way to hospital with 2.6 kgs. At births baby Elly could not cry like any other normal baby. On reaching Rwamwanja HC III and upon examination, the baby had a blocked airway, could breastfeed and breath well. A decision was made to place baby Elly in the new-born intensive care unit and be put on oxygen. After 2 weeks in the NICU, baby Elly started crying, breathing and moving his limbs. They were discharged and told to monitor him from home. Twinomujuni Ezra, the father is all praises for the midwives at Rwamwanja NICU for saving his son’s life. He says since then they have never gotten any health problem with baby Elly. He is now 6 months old.

Background to Rwamwanja HC III

Rwamwanja health centre is a high volume HC III, serving a big catchment area. It serves a total population of 87,304 people (42, 280 nationals and 45,024 refugees). The facility offers emergency obstetric surgical services and is a referral for the nearby heath centre IIIs. On average a month, Rwamwanja delivers a total of 380 babies.

Some of these babies are born with complications and find themselves admitted into the new-born intensive care unit for specialised treatment and management. According to Musiime Prever, the midwife in-charge of the NICU, says on average they receive 30-60 neonatal complications managed at the facility NICU. Before the establishment of the NICU, all babies with complications used to be referred to Rukunyu hospital and Fort Portal hospital and used to lose a number of neonates en-route.

Alex Mwesige, the in charge of Rwamwanja HC III, says before the establishment of the NICU (October 2021), most of the referral outs were neonates and we would lose many on the way before they reach Fort Portal referral hospital.

Common issues managed in the NICU

According to Prever the NICU in charge, out the 45 cases admitted to NICU in the month of July, only 7 cases were referrals from nearby health facilities, most of the other admitted babies are delivered at Rwamwanja and born preterm. In June, there were 22 nationals and 23 refugees admitted in NICU.  Most babies admitted are born tired and require oxygen to support their lungs to breath well. Other cases have neonatal sepsis (babies who cannot breastfeed right away after birth), high fever and jaundice. Preterm babies spend between 1-2 weeks in NICU before their situation improves and are discharged. For babies are born with birth abnormalities, these are normally referred to Fort Portal referral hospital for further management. Rwamwanja HC III NICU has 2 incubators, 4 beds and several warmers, four midwives are attached to the facility and work in shifts. The ministry of health through the Uganda Reproductive Maternal Child Health Improvement Project and the Belgian supported Leveraging Strategic Health Financing for Universal Health (LSF) project are supporting the capacity of health facilities handle maternal and child emergencies.

What other health workers at Rwamwanja HC III say about the NICU
 According to Arinaitwe Mary Usta, the midwife at Rwamwanja HC III attached to maternity, says they deliver about 12 mothers per day. And some babies are born with abnormal symptoms (cannot cry at birth, have abnormal breathing rate and pulse, some even develop high temperature and infections), we normally refer such cases to NICU for further management.

Midwife Arinaitwe Usta further echoes how the NICU has saved babies lives and reduced the death rates. She says in the past some babies would die in maternity ward, others would die in transit to Rukunyu hospital.

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