Mitandi is one of the areas that in our government policy we always call hard to reach areas. It took us wrong turns before we got our way around to the Mitandi health center in Mitandi sub-county Kabarole off Fort Portal – Kasese road.
I was with the US Mission in Uganda on a visit to US government-supported projects on maternal health and family planning. This trip was organized for Lois Quam, the Executive Director of President Obama’s Global Health Initiative (GHI). The visit to Mitandi was one to find out how the projects are fairing and the progress of Uganda government efforts to reduce maternal deaths by 50 percent in four western Uganda districts by end of 2012.
Uganda has one of the highest maternal mortality rates in the world at 435 per 100,000 live births. Mitandi is one of the difficult places to reach in Uganda where health services and indicators are always way below the national average. We found our way up the mountains to where the health centre sits atop a hill next to secondary school in the Rwenzori ranges.
Mitandi is a not-for-profit health center III run by the Seventh Adventist Church. The Health Center serves an area of about 40,000 people and it is the major health facility in the whole sub county. The nearest bigger health center is Kibiito health center IV about 20 km away.
Before 2010, Mitandi delivered less than five mothers per month; two years down the road the center delivers more than 20. This magic increase in number of women delivering at a health center that is even still understaffed is connected to a voucher system which has been getting funds from the US government.
Through Maries Stopes, implementers of this voucher project went through the villages carrying what they called ‘poverty grading’, looking out for the poorest of the poorest. A voucher would be sold to pregnant mother at 3000 shillings (less than 2 USD) and this entitled her to four antenatal checkups, free delivery and transportation in case of complications to a large health facility.