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Background/AimsDanger signs are indicators of complications easily recognised by non-clinical personnel that may occur during pregnancy, childbirth or in the postpartum period. Some maternal deaths can be attributed to a lack of information about postnatal danger signs. Most studies on knowledge of danger signs have investigated groups of participants with mixed parities, meaning there is limited research on knowledge among first-time mothers. The aim of this study was to determine first-time mothers’ knowledge of postnatal danger signs and associated factors in Uganda.MethodsThis was a cross-sectional study that recruited 358 primigravidas.Data on knowledge of postnatal danger signs and the participants’ obstetric and sociodemographic factors were collected through interviewer-administered questionnaires. A multivariable logistic regression model was used to determine factors associated with knowledge of postnatal danger signs.ResultsOf the 358 participants, 63.4% could name at least one postnatal danger sign. Factors associated with knowledge of postnatal danger signs were having secondary or tertiary education (P=0.002), attending more than four antenatal care visits (P<0.001) and having access to information platforms (P<0.001).ConclusionsThere is insufficient knowledge of postnatal danger signs among first-time mothers at Tororo General Hospital. First-time mothers require health education as they lack experience and knowledge of danger signs. The use of media sources to convey health information should be strengthened in the healthcare system.

Background/aimsIntimate partner violence during pregnancy is associated with adverse health outcomes for mothers and their unborn babies. Whereas the literature on intimate partner violence in the general population is extensive, little is known about this type of violence among pregnant teenagers, especially in resource-limited settings. This study aimed to determine the prevalence and factors associated with intimate partner violence among pregnant teenagers attending antenatal care clinics in Lira District, northern Uganda.MethodsThis was a cross-sectional study of 310 pregnant teenagers attending antenatal care clinics at the Lira Regional Referral Hospital and Ogur Health Center IV. Eligible teenagers were recruited consecutively until the required sample size was accrued. Data were collected using a structured questionnaire. Intimate partner violence was determined using the Revised Conflict Tactile Scale 2. Logistic regression analysis was performed to identify factors associated with violence during pregnancy, while considering potential confounding factors.ResultsThe overall prevalence of intimate partner violence among pregnant teenagers was 40.6%. The prevalence of psychological violence was 37.1%, sexual assault was 29%, and physical violence was 24.8%. Partner alcohol intake (odds ratio=5.00, P=0.000); polygamy (odds ratio=2.80, P=0.001) and the inability of the teenage mother to make major decisions in the home (odds ratio=2.42, P=0.006) were independently associated with intimate partner violence during pregnancy.ConclusionsApproximately 4 in 10 pregnant teenagers in Lira district, northern Uganda experienced intimate partner violence. This is higher than has been reported in the general population of pregnant women in Uganda. Intimate partner violence screening and counselling should be part of the routine antenatal care package.

Background:Although it is a cost effective tool in labour management, the partograph is not always used appropriately. The aim of this audit was to assess the initiation and completion of the partograph for women in labour at Mulago Hospital.Methods:A criteria-based audit was conducted, using patients’ files and delivery records from February to May 2016. A checklist was used to gather data and descriptive statistics computed.Findings:Of 7170 files, 256 (3.57%) had the partograph initiated. The recording of maternal wellbeing was low. For example, pulse was recorded in 20% of cases and blood pressure in 35%. Recording of vaginal examination results was 90% on admission but reduced to 57% in the first stage of labour. Similarly, recording of fetal heart rate in the first stage of labour was 62%.Conclusions:Partograph initiation was unacceptably low. Maternal well-being documentation was generally low compared to the set standard. There is need to strengthen the use of a partograph to improve care during labour

Male involvement in pregnancy and labour care has been shown to improve maternal and newborn outcomes. Nevertheless, it continues to be low, especially in low income countries. Several interventions have been suggested for supporting male involvement in reproductive health and maternity care, but no assessment has been made in terms of their effectiveness. The objective of this review was to summarise and evaluate the current evidence related to male partner involvement in maternal health. Three databases were searched electronically. This review included two randomised controlled trials and two observational studies. Two interventions emerged from the review: facility-based couple health education and workplace-based health education. These interventions showed positive outcomes regarding the presence of partners during antenatal visits, postpartum visits, childbirth, and the initiation of breastfeeding within one hour of birth among others. More rigorous research is needed into strategies for, and the effect of, including men in maternal and newborn health.

Strengthening the capacity of midwives and nurses in low- and middle-income countries to lead research is an urgent priority in embedding and sustaining evidence-based practice and better outcomes for women and newborns during childbearing. International and local travel restrictions, and physical distancing resulting from the COVID-19 pandemic have compromised the delivery of many existing programmes and challenged international partnerships working in maternal and newborn health to adapt rapidly. In this paper, we share the experiences of a midwife-led research partnership between Kenya, Malawi, Tanzania, Uganda, the UK, Zambia and Zimbabwe in sustaining and enhancing capacity strengthening activities remotely in this period. Whilst considerable challenges arose, and not all were overcome, collectively, we gained new insights and important learning which have shifted perspectives and will impact future design and delivery of learning programmes.

ABSTRACTBackground: In Uganda, perinatal mortality is 38 per 1000 pregnancies. One-third of these deaths are due to birth asphyxia. Adequate fetal heart rate (FHR) monitoring during labor may detect birth asphyxia but little is known about monitoring practices in low resource settings.Objective: To explore FHR monitoring practices among health workers at a public hospital in Northern Uganda.Methods: A sequential explanatory mixed methods study was conducted by reviewing 251 maternal records and conducting 11 interviews and two focus group discussions with health workers complemented by observations of 42 women in labor until delivery. Quantitative data were summarized using frequencies and percentages. Content analysis was used for qualitative data.Results: FHR was assessed in 235/251 (93.6%) of records at admission. Health workers documented the FHR at least once in 175/228 (76.8%) of cases during the first stage of labor compared to observed 17/25 (68.0%) cases. Median intervals between FHR monitoring were 30 (IQR 30–120) minutes in patients’ records versus 139 (IQR 87–662) minutes according to observations. Observations suggested no monitoring of FHR during the second stage of labor but records indicated monitoring in 3.2% of cases. Reported barriers to adequate FHR monitoring were inadequate number of staff and monitoring devices, institutional challenges such as few beds, documentation problems and perceived non-compliant women not reporting for repeated checks during the first stage of labor. Health workers demonstrated knowledge of national FHR monitoring guidelines and acknowledged that practice was different.Conclusions: When compared to national and international guidelines, FHR monitoring is sub-optimal in the studied setting. Approximately one in four women was not monitored during the first stage of labor. Barriers to appropriate FHR monitoring included shortage of staff and devices, institutional challenges and mother’s negative attitudes. These barriers need to be addressed in order to reduce neonatal mortality.