Kassanda Deputy RDC Advocates Greater Masaka’s One-Pool Emergency Model as Regional Stakeholders Demand Direct Audit Accountability and Aim for Under-Five Maternal Deaths.
MUBENDE: Authorities across the Mubende Region have taken a firm, zero-tolerance stance against maternal and newborn mortality, declaring that routine death statistics, missing transport, and endless excuses from health administrators must come to an immediate end.
Speaking during the regional launch of the Emergency Referral Systems (ERS) for Maternal and Newborn Health Project on Thursday at Joyce Hotel in Mubende, leadership set aggressive targets to eliminate preventable birth fatalities entirely and restrict maternal deaths to fewer than five across the five constituent districts.
Dr. Batiibwe Emmanuel Paul, Senior Executive Consultant for Mubende Regional Referral Hospital, warned health workers against normalizing preventable deaths, asserting that a woman’s death under medical supervision due to avoidable delays or negligence must be treated as unacceptable and unlawful.
“We must stop narrating stories when a life is lost. Moving forward, every death must trigger a thorough audit to establish the ultimate why—why did the patient die, and who precisely failed to perform their duty?” Dr. Batiibwe declared.
Adopting the Greater Masaka “One-Pool” Ambulance Model
Adding a practical strategy to bridge the region’s transport bottlenecks, the Deputy Resident District Commissioner (RDC) for Kassanda called upon regional health stakeholders to adopt a centralized “one-pool center” model for ambulance operations, drawing inspiration from success stories in the Greater Masaka region.
Under the proposed model, all public and partner-supported ambulances across the five districts would be consolidated into a unified command and dispatch system:
Resource Pooling: Financial resources, fuel allocations, and Primary Health Care (PHC) emergency funds are placed into a single basket to ensure vehicles are never grounded due to fuel shortages.
Real-Time GPS Tracking: Fleet tracking technology monitors the exact location and availability of every ambulance in real time, enabling rapid deployment.
Elimination of District Boundaries: The nearest available ambulance is dispatched to critical cases regardless of administrative borders, dramatically reducing emergency response times during the critical “golden hour.”
“The one-pool center model in Greater Masaka has significantly cut down emergency response times and eliminated delays in critical healthcare, especially for expectant mothers,” the Kassanda Deputy RDC noted, urging the Ministry of Health and project partners to replicate the setup in the Mubende cluster.
Alarming Regional Indicators:
Technical reports presented at the meeting indicated that while Uganda’s national Institutional Maternal Mortality Ratio (IMMR) dropped by 25% over the past five years (from 92.1 to 69.1 per 100,000 deliveries), the Mubende region lags behind with an IMMR of 81 per 100,000. Kiboga District posted the highest mortality rate in the region at 120.5 per 100,000.
Of the 48 maternal deaths recorded in the region in FY2024/2025, Postpartum Haemorrhage (54%), Hypertensive disorders (22%), pregnancy-related sepsis (8%), and anaesthetic complications (5%) were the leading causes. Perinatal mortality also remains high at 19.2 per 1,000 births compared to the 15.4 national average.
The high-level regional meeting was organized by Mubende Regional Referral Hospital in partnership with the Ministry of Health and the Clinton Health Access Initiative (CHAI), drawing leaders from Kassanda, Kiboga, Kyankwanzi, Mityana, and Mubende districts.
Name-by-Name Audit Accountability
To enforce compliance, Maternal and Perinatal Death Surveillance and Response (MPDSR) audit panels across 244 health facilities will no longer rely on anonymized system summaries. Audits will directly log:
Attending Doctors & Specialists: Notification time, physical arrival time, and time to surgical intervention.
Facility In-Charges: Adherence to early pre-notification protocols before transferring emergency cases.
Midwives and Nurses: Rigor in monitoring vital signs and triage speed.
Ambulance Operators: Dispatch promptness and enforcement of strict zero-extortion policies against patients.
While administrative issues like e-health DHIS2 system downtime and power fluctuations are being addressed through infrastructure investments, regional leaders cautioned that duty-of-care failures and administrative negligence will attract swift administrative and legal consequences.
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