Bududa, Uganda | URN | Expectant mothers at Bulucheke Health Centre IV in Bududa District are struggling for space, with some forced to share beds while others sleep on the floor as patient numbers surge at the facility. The shortage of beds and space has become a major challenge at the maternity ward following the upgrade of the facility from a health centre III to a health centre IV, an intervention intended to improve access to healthcare and ease pressure on Bududa Hospital.
The facility now serves more than 50,000 people annually from a catchment area covering more than 10 sub-counties, putting pressure on its maternity ward and outpatient department. For mothers seeking maternity services, the challenge is not the quality of care provided by health workers, but finding a place to rest before and after delivery.
Evaline Nasikye, a resident of Busiriwa Sub-county, said health workers provide good services, but the shortage of beds makes it difficult for mothers to recover comfortably after giving birth. Nasikye said she had previously been taught at the facility that mothers should rest for about six hours after delivery, but the shortage of space makes this difficult.
“The health workers provide good services, but the challenge comes when it is time to sleep. There are not enough beds and space,” Nasikye said. She said some mothers have reportedly been discharged earlier than expected because of the limited space and appealed to the government to intervene.
Another mother from Kikhoolo Town Council, who had accompanied her daughter to the facility, said health workers received them well when they arrived at about 1 pm. Her daughter was attended to and delivered later that night, but the family faced another challenge after the delivery when they could not find a place to rest. She said all the beds were occupied and there was not enough space even to put a mattress on the floor.
She appealed to the Ministry of Health to expand the facility and provide adequate accommodation for mothers and other patients. James Wanuba, who accompanied his wife to the facility from Buwali, said they walked through the rain at about 9 pm and arrived an hour later. He said health workers welcomed them and attended to his wife until she delivered, but he also witnessed the shortage of beds and space.
“The health workers have love for their work, but space and beds are a big challenge,” Wanuba said. Dr Rashid Simuya, the facility’s in-charge, said the number of patients has increased significantly since the health centre was upgraded. He said the facility previously received between two and five mothers for antenatal care each day, with about two to three expectant mothers requiring maternity admission.
The numbers have since risen to between 20 and 30 mothers seeking antenatal care daily, while between six and 10 expectant mothers now require maternity services each day. Simuya said the facility has only six maternity beds, which cannot meet the growing demand. “The number of mothers coming for maternity services has increased, yet we have only six beds,” Simuya said.
The shortage has forced some mothers to share beds, while others sleep on the floor as they wait to deliver or recover after childbirth. The outpatient department is also under pressure, with Simuya saying daily attendance has increased from between 20 and 50 patients to more than 100.
He appealed to the government to construct additional maternity wards and expand other facilities to enable the health centre to cope with the increasing number of patients.
An upgrade that brought more patients
Bulucheke Health Centre’s history dates back to the relocation of people affected by the Nametsi mudslides. The government transferred health services from Nemetsi to Bulucheke after people affected by the mudslides were relocated to Bulucheke Sub-county. The facility was initially established as a health centre II to serve the displaced community.
Although the community was later relocated to Kiryandongo, the facility remained and continued serving surrounding communities. It was subsequently upgraded to a health centre III under the government’s programme to upgrade health centre IIs before being elevated to a health centre IV.
At the time of its earlier upgrades, the facility served an estimated 5,000 to 10,000 people annually. The upgrade to a health centre IV was intended to bring better health services closer to the population and help decongest Bududa Hospital. But the improved services have attracted more patients, stretching the facility’s existing infrastructure beyond capacity.
Temporary relief
With the shortage becoming increasingly urgent, the Health Unit Management Committee has turned to Primary Health Care funds to construct an additional structure. Zipora Wamoto, the committee’s chairperson, said the structure is still under construction and is intended to provide temporary relief as the community waits for permanent government intervention.
“It is not the responsibility of the management committee to construct health facilities, but we had to respond to the need because the situation required immediate action,” Wamoto said. She appealed to the government to expedite construction of additional facilities at the health centre.
For mothers arriving at Bulucheke in search of safe delivery, the struggle does not end with receiving medical attention. Finding somewhere to rest has become part of the challenge. The situation highlights the growing gap between demand for maternity services and the infrastructure available to provide them following the health centre’s upgrade.
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