General
East Africa’s high maternal death rate
Judith Awino died on her 25th birthday as she gave birth, on a dusty roadside, to her second child.
She had endured a long and difficult labour but was unable to get admitted to hospital because of a nurses’ strike.
Her baby also died.
Her short life symbolises the tragedy behind the high maternal death rate in Kenya where the maternity system faces extreme pressure.
Whereas Kenya’s overall crude death rate is on a par with Europe, its maternal death rate in 2015 was 43 times higher than that seen in high-income countries?—?with 510 women dying in every 100,000 live births.
And that picture is not just restricted to Kenya.
Across Africa, countries are unlikely to hit the Sustainable Development Goal to significantly reduce preventable maternal deaths.
A team from the University of Leeds, Makerere University in Uganda and the Catholic University of Eastern Africa is investigating a new approach to improving maternal health. It is funded by the UK’s Global Challenges Research Fund (GCRF), money from the UK’s aid budget with the aim of bringing the best research to target the big, intractable problems facing the world.
The UK Government believes research excellence is achieved by people from different academic backgrounds working in collaboration and across borders.
The project in Kenya has researchers with a medical humanities background working alongside medical and public health specialists, bringing fresh insight into why maternal death rates are high.
One of the issues that’s emerged is that a high proportion of pregnant women seek maternity care very late in their pregnancy.
Jane Plastow, Professor of African Theatre in the School of English and History at Leeds, said her approach is to use drama-based workshops to allow women and their families to feel at ease in speaking about their experiences or to act out what has happened to them.
Professor Plastow said: “We have been able to show that there are good reasons why many poor women are not able or willing to interact with health professionals and these need to be much better understood and taken into account if services are to respond well.
“The research is revealing that the challenges facing women are immense. Most people using the public health service are poor and live in remote villages, and for many it was impossible or costly to access antenatal care.”
She also commented that people felt ambulances could not be relied on. The women spoke about being treated badly when they went for antenatal advice or went into labour?—?with feelings that nurses would be dismissive, disparaging or judgmental, particularly if they regarded the patients as poor or illiterate.
Maternity units were reportedly overwhelmed, with many women not being assessed quickly enough. Both hospitals and rural clinics lacked blood products and equipment.
The research is suggesting that women have become more vulnerable because of the changes in the support they get from their families, sometimes with women under pressure to return to work days after giving birth.
Shane Doyle, Professor of African History at Leeds who is leading the project, said: “One of our goals is to encourage hospitals to adapt their maternal health provision in light of this research, so that, for example, greater attention is devoted to ongoing care and delivery and discharge.”
The researchers are working with Kenyan TV to reveal the problems faced by poorer women and it will feature the case of Judith Awino.
The project will also look at the relationship between patients and healthcare staff who often work under extreme pressure.
Professor Doyle added: “One of our aims is to show that this cross-cutting research opens up a fresh understanding of the experiences of pregnant women and health care workers.
“Kenya has attempted to improve the maternal death rate by introducing free maternity services and opening new hospitals but they’ve not had the impact that was hoped.
“Research that understands the socio-cultural issues and health issues in maternal death rates is likely to suggest more sustainable ways of tackling the problem.”
The University of Leeds has been hugely successful in securing support from the Global Challenges Research Fund. It was established in 2016 and over five years will allocate a total of £1.5 billion to UK science with the aim, the Government said, of ensuring Britain meets its “…moral obligation to the world’s poorest.”
The UK Medical Research Council awarded the GCRF grant. Dr Mark Palmer, Director of International Relations at the MRC, said: “Improving on maternal and neonatal health is a major global health challenge that we are committed to tackling.
“This research is pivotal to better understanding why maternal death rates are so high, taking a multidisciplinary approach to gain insight into how to help pregnant women, along with the healthcare workers and communities that support them. The findings could lead to positive changes and better outcomes for maternal health around the world.”
The University of Leeds is involved in 70-plus projects financed through the fund covering a range of issue from equipping scientists in the developing world with technology to safely make vaccines, low-cost endoscopy for stomach cancer and the ways people can protect themselves from the kidnapping epidemic in Mexico.
Find out more about the University of Leeds and GCRF.
Other GCRF stories:
On 20th January 2025, the blazing afternoon sun was temporarily obscured by cloud cover as a convoy complete with VVIP security detail quietly made its way to the Main Building. As the convoy came to a stop at the Main Building’s Eastern staircase, all eyes were peeled to see who this VVIP was. As she emerged, there was no fanfare whatsoever as she proceeded to pleasantly greet the welcoming party. Princess Zahra Aga Khan, graceful by all standards, had arrived at Makerere University, an institution fondly talked about by her father His Late Highness Prince Karim Aga Khan IV.
It was indeed humbling that Princess Zahra Aga Khan, a Member of the Board of Directors of the Aga Khan Development Network (AKDN) and Trustee of the Aga Khan University (AKU) could include Makerere University on her itinerary. She had earlier on the same day paid a courtesy call on the President H.E. Yoweri Kaguta Museveni at State House Nakasero, and presided over the graduation of 120 students of the Aga Khan University-Kampala.
Princess Zahra who was received by the Acting Vice Chancellor, Prof. Buyinza Mukadasi and the Dean Makerere University School of Public Health (MakSPH), Prof. Rhoda Wanyenze was thankful for the warm reception and Makerere’s unwavering legacy.
“My whole life, my father always told me that Makerere was the best University in Africa,” relayed Princess Zahra, before adding “And my whole life he told me how sad it was that tertiary level degrees had been de-funded and what fragility that bred in these countries.” She went on to explain that her father’s philosophy was that if a country cannot train its upper degrees, it cannot build a free, fair and successful economy.
Princess Zahra nevertheless expressed how glad she was to see that Makerere still remains a beacon of higher education, and that the Main Building that was gutted by fire was reconstructed to perfection. “So to come here and see it looking so amazing and beautiful is really good.”
She confessed that her itinerary, though involving many hops to preside over graduations in Kenya, Tanzania and finally Pakistan, was testimony of how much Aga Khan Institutions had evolved over the past twenty years. Princess Zahra explained that partnerships with Makerere and other universities, especially in the aftermath of events such as CoVID-19, were crucial in helping Aga Khan Institutions to adjust. “An institution can become far stronger and more resilient,” she explained.
In his welcome remarks, Prof. Buyinza thanked Princess Zahra for including Makerere on her eventful itinerary. “We are more than a century old and have greatly impacted the development and economy of this country, not on our own, but with the big network of our partners in many respects. Your coming reinforces the resolve that we must work together for the good of humanity.”
The Acting Vice Chancellor equally welcomed members of Princess Zahra’s delegation who included; her daughter Sarah Boyden, Mr. Zakir Mahmood-Chairman Board of Trustees AKU, Mr. Amin Mawji, OBE-Trustee AKDN, Dr. Sulaiman Shahabuddin-President and Vice Chancellor AKU, Dr. Tania Bubela-Provost and Vice President Academic AKU, Zeenat Shahabuddin-Regional CEO for Aga Khan Health Services (AKHS) in East Africa, and Joseph Mwizerwa-Associate Vice Provost AKU-Uganda.
Contributing to the day’s discussion, Dr. Sulaiman Shahabuddin the President and Vice Chancellor AKU who has been in Kampala for the last twenty years, admitted that the new campus in Nakawa heralds a new era of growth as they commence student activities in June 2025.
“Makerere has been and is a distinguished University in Africa. We look forward to engaging and discussing how best we can come up with programmes that can benefit Uganda and Ugandans” he remarked.
As a rejoinder, Prof. Rhoda Wanyenze admitted that AKU’s and Makerere’s academic programmes present a number of potential synergies both in training and research. “Cancer clinical care and research is a big issue for us here; the burden is growing and we need to do more work to be able to characterize exposures and what it is that’s driving it.”
Other areas singled out in the discussion as potential for collaboration included; the environment, climate change and its linkage with health and other issues, and harnessing of the potential Electronic Medical Records (EMR). Makerere University currently partners with the Ministry of Health to roll out EMR systems nationwide, so as to optimize health service delivery in line with the Uganda Vision 2040.
“We have already done quite a number of facilities across the country for HIV, probably more than 1,000, but right now we are moving towards having an integrated electronic system for all care, the interoperability of multiple systems that exist, and being able to scale that up” complemented Prof. Wanyenze.
Prof. Buyinza who brought the lively discussion to a close concurred that a lot of potential areas for collaboration exist between the two partners and reassured Princess Zahra Aga Khan and her delegation of the Makerere’s readiness to undertake joint activities for the good of humanity. He also used the occasion to observe a moment of silence in honour of His Late Highness Prince Karim Aga Khan IV, who passed away on 4th February 2025.
Following the signing of the Vice Chancellor’s Visitors Book, Princess Zahra Aga Khan and her delegation proceeded to the Makerere University Innovation Pod (Mak UniPod), where they received a guided tour from Dr. Cathy Ikiror Mbidde, the Director.
Prof. Henry Alinaitwe on 20th February 2025 officially handed over the Office of Deputy Vice Chancellor (Finance and Administration)-DVCFA to Prof. Winston Tumps Ireeta at a ceremony presided over by the Acting (Ag.) Vice Chancellor, Prof. Buyinza Mukadasi. The handover was witnessed by the University Secretary-Mr. Yusuf Kiranda, Chief Human Resources-Mr. Deus Tayari Mujuni, Chief Internal Audit-Mr. Patrick Akonyet, University Bursar-Mr. Evarist Bainomugisha and Chief Legal Affairs-Ms. Nanyondo Sumaiyah Sebuta.
Equally present to witness the ceremony were the Chief Estates and Works- Eng. Okuk Geoffrey, Dean of Students-Dr. Winifred Kabumbuli, Deputy University Secretary-Mr. Simon Kizito, Mr. Juma Katongole-Representing Director ICT Support, Ms. Susan Mbabazi-Representing Director Gender Mainstreaming, Ag. Manager of Planning and Development-Mr. Emmanuel Kitamirike as well as staff from the Vice Chancellor’s and Deputy Vice Chancellors’ Offices.
Prof. Buyinza Mukadasi in his remarks thanked Prof. Alinaitwe for the effort and support rendered to the University through the DVCFA’s Office and prayed that Makerere could continue tapping into his knowledge.
“As colleagues we have a shared agenda and a common destination as we do the best for Makerere. I thank Prof. Henry Alinaitwe for being a hardworking colleague of great humility, collegiality, and being open-heartedly committed to the principle of trust” remarked Prof. Buyinza, who also expressed belief that God has bigger plans for him as he exits office.
In the same breath, Prof. Buyinza congratulated Prof. Ireeta on his new role, admitting that he has what it takes to carry on from where his predecessor left off. “Thank you for accepting to take on this appointment; it takes a person of great responsibility to accept the huge mandate of this office.”
The Chief Human Resources Officer, Mr. Mujuni thanked Prof. Alinaitwe for steering the Office of the DVCFA and pledged to correspondingly support his new supervisor, Prof. Ireeta. The University Secretary, Mr. Kiranda equally thanked Prof. Alinaitwe for the guidance, support, and flexibility accorded to his office to fulfil its mandate.
“Although it is difficult for us to sit here and witness this handover, we are comforted to have previously worked with Prof. Ireeta and look forward to the continuity in service that his experience presents” added Mr. Kiranda.
The Chief Internal Audit Officer, Mr. Akonyet in his tribute thanked Prof. Henry Alinaitwe for his guidance as immediate supervisor, which helped shape the internal audit function. Like Mr. Kiranda, Mr. Akonyet thanked Prof. Ireeta for his support as a member of the University Council’s Audit Committee and expressed confidence that his passion for service would greatly benefit the University in his new role.
Presenting his handover report, Prof. Henry Alinaitwe reflected on a number of achievements such as: Mobilising resources for the Makerere@100 Celebrations and other activities; establishing the Grants Administration and Management Support Unit (GAMSU); realigning Makerere’s Ten-Year Strategic Plan to the Five-Year NDP-recommended interval; Payment of outstanding In-house Benefits; Harmonization of staff salaries; as well as Recruitment, Promotion and Training of staff.
Prof. Alinaitwe equally highlighted achievements such as: Formulation of the ICT Policy and purchase of related equipment; Developing a Security Masterplan and enhancing surveillance, personnel numbers and equipment; Support to Student Affairs Management and Governance including overseeing the Emerging Leaders Program; Renovation of Student Halls of Residence; Establishment of the Disability Support Centre; Leading the Design Team for the Reconstruction of the Main Building; Improving Competitiveness of the Staff Housing Policy; Improving the University Fleet and Vehicle Access Control; Improving the Budgeting Process through Unit Ledgers and Accounts; among others.
He concluded by thanking the University Council and the Vice Chancellor for entrusting him with the role of DVCFA as well as all the support rendered to his office in the execution of his duties. “Whereas I have read out all these various achievements, they have largely been due to all your respective contributions and I thank you for that.”
In his acceptance remarks, Prof. Winston Tumps Ireeta similarly thanked the University Council and Vice Chancellor for entrusting him with the responsibility of overseeing the Office of the DVCFA. He acknowledged that despite the fact that he was taking over from Prof. Alinaitwe on whose behalf he had acted a number of times, he still has big shoes to fill. “However, with my God, all things will work out” he prayed.
The incoming DVCFA requested Prof. Alinaitwe to always accept consultation on matters relating to the office and pledged to be as results-oriented as his predecessors. “Let’s all work together for the good of our University” he concluded.
Following the Handover Ceremony, Prof. Buyinza Mukadasi on behalf of Members of Management presented a plaque to Prof. Henry Alinaitwe in appreciation of his dedicated service as Ag. DVCFA from 16th November 2021 to 19th February 2025.
In a pivotal meeting held earlier this morning, the Acting Deputy Vice Chancellor, Prof. Henry Alinaitwe, met with project implementation partners from the Korea Institute for Development Strategy (KDS) and the Korea National Open University (KNOU) to discuss the upcoming Project for Enhancing the Distance Education Environment at Makerere University in Uganda (2024-2028). This collaboration, set to launch on February 27, 2025, is poised to revolutionize the university’s distance learning initiatives.
The project, which is generously funded by the Korean Government through KOICA (Korea International Cooperation Agency), will receive a substantial investment of USD 12.2 million. It aims to address critical areas in e-learning at Makerere University, with key components focusing on the development of a comprehensive e-learning master plan, capacity building for staff in Open and Distance eLearning (ODeL), equipping two state-of-the-art content development studios, and the development of necessary infrastructure.
Prof. Henry Alinaitwe expressed his enthusiasm for the partnership, stating, “This project marks a significant milestone for Makerere University as we strive to enhance our distance learning capabilities. The integration of advanced technology and capacity building will not only improve the quality of education but also ensure greater accessibility for learners across the region. We are grateful for the generous support from the Korean Government and look forward to the successful implementation of the project.”
The delegation from Korea, led by Prof. Chun Se yeoung, also expressed their commitment to the success of the project. Prof. Chun Se yeoung remarked, “We are excited to partner with Makerere University on this transformative project. We believe that by enhancing the distance education environment at Makerere, we will not only benefit the university but contribute to the development of higher education in Uganda and the broader East African region. Our goal is to build a sustainable and scalable model that empowers educators and students alike.”
The project is expected to have a lasting impact, significantly strengthening Makerere University’s capacity to offer high-quality education remotely, thereby increasing access to learning opportunities for students across Uganda and beyond.
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