Beating the Clock:

Irene Namuli, 50, recalls a moment from her nursing career when a young mother in the second stage of labour, was rushed to the small health centre where she worked. 

Her patient’s blood pressure had spiked dangerously, her face was swollen, and she was disoriented,“ Namuli says.

She was convulsing, and I knew we had little time. With no doctor on site and limited resources, Namuli relied on her training and instincts. She quickly administered magnesium sulphate to stabilize the mother while coordinating with a nearby hospital for an emergency caesarean section,” Namuli says. 

This is the story the retired nurse speaks of passionately while speaking about the challenge of pre-eclampsia, one high blood pressure (hypertension) disorder that can occur during pregnancy.

It is a significant public health problem in Uganda, ranking as the second leading cause of maternal mortality after postpartum hemorrhage. Reports indicate that it accounts for 16% of all maternal deaths.

For Namuli’s case, both the mother and her baby survived, a victory Namuli attributes to quick action and the availability of essential drugs. 

“That day, I saw the difference a nurse can make when the system works,” she says speaking to the absence of healthcare workers in the country’s public health system.  

To understand the broader context of these conditions, Dr. Agaptus Mukasa, a private medical  doctor says the challenge starts and ends with the absence of an enabling support infrastructure.

The persistence of eclampsia-related deaths in Uganda points to a broader issue of public accountability and transparency in the health system. Despite progress in maternal health, gaps in data reporting and resource allocation hinder effective interventions. 

Only 50% of health facilities in Kampala reported complete data on deliveries and maternal deaths from 2016 to 2021, with smaller clinics often reporting zero values due to lack of capacity. 

Maternal death audits, critical for identifying preventable causes, were conducted in only 33% of cases at a major Kampala hospital between 2016 and 2018, with a median audit time of 132 days—far too long to drive timely improvements.

Dr. Mukasa stresses that transparency in reporting maternal deaths and allocating resources is essential. 

“We need to know where and why women are dying to prioritize interventions,” he says. “Without consistent data and accountability, we’re fighting blind.” 

The Ministry of Health has made strides through initiatives like the Maternal and Perinatal Death Surveillance and Response (MPDSR) system, but implementation remains uneven, particularly in rural areas. Fighting Eclampsia in Kampala:

One of the many organisations trying to make  a difference in Kampala is the Kampala Maternal Newborn Slum Project (2019-2021), which focused on improving maternal health in underserved urban areas. 

The project established an emergency call and ambulance dispatch centre to enhance referral coordination, addressing delays in reaching care. 

It also supported weekly MPDSR meetings and quality improvement mentorships, fostering accountability and better outcomes. 

“Such initiatives show what’s possible when resources and political will align,” Dr. Mukasa says. “But we need more sustained efforts, especially in rural areas like Mityana.”

Namuli’s story of saving a mother and baby in Banda Busujju is a testament to the power of skilled healthcare providers, but it also highlights the fragility of Uganda’s maternal health system. 

With pre-eclampsia and eclampsia claiming thousands of lives annually, urgent action is needed. Strengthening antenatal care, ensuring access to magnesium sulphate, and improving data transparency are critical steps. 

Organizations like the Kampala Maternal Newborn Slum Project offer a model for change, but scaling up these efforts requires government commitment and community engagement. As Dr. Mukasa puts it, 

“Every maternal death is a tragedy, but it’s also a call to do better. We have the tools to prevent eclampsia deaths. Let’s use them,” he says. 

For Namuli, the memory of that mother’s survival fuels her hope: “I retired, but the fight goes on. Every woman deserves a chance to hold her baby safely.