Bunapongo Health Centre III, a facility in Mbale District – Eastern Uganda, with one delivery bed and one recovery bed – serving a population of 16,841 people.
Bunapongo is a government owned and run Health Centre at grade III level. The facility serves 5 parishes comprised of 84 villages with a total population of 40,395 according to the USAID RHITES.E. activity report of 2022. This particular area is where the main Bagisu annual cultural celebration (Imbalu) is held every even year. The Imbalu celebration draws mainly teenagers who are sexually active and are prone to HIV as well as teenage pregnancies. Teen expectant mothers, who present at this Health Centre end up with complications during delivery that require specialized handling. Maternal and child deaths have been registered and also increasing cases of fistula. Records at the facility show that they serve about 16,841 persons per annum, majority of whom are for maternal services.
The Health Centre is managed under the Mbale District Local Government leadership and is headed by a Senior Medical Officer who works with 11 personnel. The facility operates on a 24-hour basis and offers some services to the public at a free cost while others are cost shared. Other services like baby incubation, ultra sound services and x-ray services are not offered at the health center therefore, patients are referred to Mbale Hospital which is about 10 kilometers away.
Immunization, disease surveillance, prevention and control, some ante-natal services, HIV counselling and testing are given at no cost to the public; while family planning and maternal services are cost shared with the public. For surgeries, the Health Centre refers the patients to Mbale Referral Hospital due to lack of facilities at the Health Centre.
The Rotarians and the Bunapongo community, together with the International Sponsors can foster the desired interventions to improve the reproductive health, maternal and child health which are the areas of concern. The Vision is to equip the maternity and children wards, provide a quick means of transport to facilitate referrals of especially mothers and newborns to the main hospital when the need arises and to rehabilitate the Immunization hall to enhance service delivery as well as mitigate the risk of high mortality rates of both mothers and newborns at this health center.
Statement of the problem:
Bunapongo Health Centre III serves a rather big population compared to the amenities at the facility; the staffing level, services offered and equipment used. According to the hospital records, on daily basis, there are 3 -5 women giving birth at this facility; yet the small delivery room has only one old metallic bed which serves as the delivery bed, next to the treatment and recovery rooms that cater for all other patients. This leaves the expectant mothers with no privacy nor dignity in giving birth and poses a high risk of disease exposure to the newborn babies.
Expectant mothers have to wait in queue for their turn, in the event that another mother is in labor as space and beds are not adequate to host more than one expectant mother in the delivery room. Complications can arise and lives can be lost as women in labor wait for those in the delivery room. After giving birth, only two mothers can be accommodated in the recovery room with their babies due to inadequacy of space, beds and baby management facilities. New mothers can also be discharged immediately in case there are more than two deliveries in a day; posing a huge risk on the health of the mothers and their babies. This results into foregoing the much-desired postnatal care which can lead to over bleeding and fatal deterioration of the health of both the new mothers and babies. The facility lacks appropriate means of transport, hospital and delivery beds and basic ante-natal/post-natal care equipment yet it serves many expectant and new mothers. This subsequently limits the Health Center III in providing the desired maternal services.
Value proposition:
Bunapongo Health Centre III is strategically positioned at only 10 kilometers away from Mbale City where the Main hospital and District Health offices are located. Local government through the District Health Office and the community are willing to partner with Rotarians to monitor the progress of the Project, while the Rotarians and the International community will equip and furnish the wards to enhance ante-natal and post-natal care services.
This Project is being undertaken by 3 Rotary clubs who will contribute USD 12000 towards the furnishing and equipment, which will be matched by the Districts and the Annual Fund.
Conclusion:
In summary, the Bunapongo project aims at improving reproductive health services, maternal and child health services; by equipping the wards and delivery room; procuring a sustainable means of transport to facilitate main hospital referrals, training of medical staff and training of the expectant and new mothers in the community. Consequently, Bunapongo’s strategic position, and an adequately equipped facility will enable the Health Center to efficiently handle more mothers and children from the 84 villages, reduce the maternal and child mortality rates as well as improving service delivery in totality.
The Rotary Clubs of Lubowa, Kajjansi , Mbale City and the International Sponsors will all join hands to bring this project to fruition at a Total Project cost of 410,745,000/=(Four hundred and ten million, seven hundred and forty five thousand shillings.) which is an equivalent of USD $108,662.68(One hundred eight thousand, six hundred and sixty two dollars)