Maternal and neonatal health indicators in Uganda are very poor: the maternal mortality rate is 438 maternal deaths per 100,000 live births, while the child mortality rate is 54 deaths per 1,000 live births. The study presented here was carried out in the Karamoja region, an area where Doctors with Africa CUAMM has been active for more than 30 years. It aimed to analyse the availability of maternal and neonatal health care services at every level of the health system and to assess both the population’s use of them and their quality.

The data collected during the study pointed up a serious lack of infrastructure, tools, medicines and health care personnel, particularly in peripheral health care centers. Use of the services that were available to the community – pre- and post-natal visits and assisted delivery – was low in any case, highlighting the need to further engage with and raise awareness among the local population. Furthermore, there were serious problems with the quality of the services being provided. Indeed, some health care facilities identified as EMOC providers failed to meet the basic criteria for being defined as such. There is therefore a need to re-orient health care personnel towards maternal and child health care in order to achieve the necessary standards of care. There is also an urgent need to improve both the availability of BEmONC services and the local population’s access to them.