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Availability of Preeclampsia Drugs Low in Private Hospitals -Experts

Dr Denis Kibira, the Executive Director of HEPs Uganda says the low stock in private facilities is because hospitals are not willing to spend money to procure the drugs
Private hospitals lack essential drugs for treating pre-eclampsia. Pre-eclampsia is a common condition in pregnant women who present with high blood pressure.

It often leads to complications for the expectant mother and baby. But for so many women in Uganda who develop the condition, it is not managed because many private health facilities do not have the drugs or equipment needed to detect and control it.

In the management of the condition, magnesium sulfate is used to stop seizures while methylpoda is used to manage blood pressure.

However, data from the health ministry shows that only five percent of private health facilities have magnesium sulfate stocked while only 12 percent have methyldopa. Nine percent have calcium gluconate compared to public health facilities where at least 30 percent have all the three essential medicines.


With such low stocks, health experts want the government to intervene and make it mandatory for private facilities to have higher stocks of the drugs.

Dr Denis Kibira, the Executive Director of HEPs Uganda says the low stock in private facilities is because hospitals are not willing to spend money procuring the drug.

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Data from the health ministry indicates that 47 percent of all Ugandan pay for health care out of their pockets. The majority, especially those in urban centres prefer private health care facilities compared to government facilities that often are considered to have sub-standard care.


Dr Evelyn Nabunya, the Executive Director of Mulago Women’s Neonatal Hospital, says that often, the lack of life-saving medicines in private facilities leads to deaths in government-owned facilities.


"We register many cases of death but this is because many women are referred to us at the last moment when the situation has worsened. Pre-eclampsia accounts for at least 40 percent of deaths in mothers," she said.

According to the World Health Organization, over 99% of pregnancy-related deaths occur in low-and middle-income countries, including Uganda. Out of the 6,000 maternal deaths reported in the country annually, 550 of those that are reported are due to the pregnancy complication.

According to a 2017 survey carried out by Kampala Capital City Authority-KCCA, there are over 1000 health facilities in Kampala. More than 80 percent are private facilities.

Grace Ssali Kiwanuka, the executive director of Uganda Health Federation, an umbrella body that brings together private health care providers says that many privately owned health centres cannot afford to procure the necessary medicines and equipment that could be used to manage pre-eclampsia.


Kiwanuka says the government needs to step in and offer assistance to small private health facilities that offer antenatal services to many women but do not have the necessary equipment to treat or identify the complication.


"Many mothers go to those small neighbourhood clinics for assistance. The big private health centres are visited when the time for delivery reaches but often at that point it is too late for anything to be done, “she said.

Kiwanuka says the government needs to consider entering into cost-sharing agreements with small health facilities to make sure they have the necessary equipment and drugs at an affordable but life-saving care to all expecting women.

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