Dr Nakakeeto is registering more gains in Ugandan Neonatal care.

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By Eddie Ssemakula

For over 15 years as a neonatologist, one of Dr Margaret Nakakeeto’s goals has been to establish a newborn care system that would allow for the cultivation and sustenance of sustainable responses to infant and preterm care.

“After beginning at zero in 2020, we have now established Neo-natal units, particularly in West Nile. Health centres IVs now have health units there, and there is currently hope that they can manage and run Neo-natal units.” There has been significant progress. She states

According to Dr. Nakakeeto, monitoring the developmental follow-up of infants will be the next step, since many kids are released in good health but only live for a few weeks, and many of them hardly make it to their first birthday.

She also draws attention to the renewed public knowledge of newborn care, and she is happy that both the government and a large number of the commercial sector are supporting this cause.

“We have begun constructing modern units in Kamuli, Kasese district in Bwera, “ she adds “which is opening this month. Kasese, for instance, the district has one hospital that is practically located at the border, and many frequently visit it because it is free, they understand that newborn care needs to last many days, so the expenses can be significant, and we are there helping.

Along with highlighting how most WHO requirements are being followed and neonatal guidelines and protocols are being pursued and set up, Margaret also highlights the many mentorship programs that are taking shape. She describes this journey as “not perfect but good progress.”

“Previously too,” she adds “the majority of data came from maternity registers, but now that Neonatal Registers are collecting data as well, babies are considered their own patients in government facilities too, a thing we only saw in private hospitals before.”

She reports that babies now have their own IP number, a revised 108, which allows for the independent reporting of new data.

“We have spent the last 20 years trying to ensure some of these things. The World Neo-natal Day has also become prominent on our calendar” World Premature Day too is becoming more and more common these days due to increased mobilisation around it. There has been so much success that we have even launched a new magazine.”

Margaret observes that while there are numerous obstacles to overcome in the field of neonatal care, there are also many opportunities, particularly given the district-level infrastructure currently in place and the availability of neonatal equipment.
She recognizes, “We can now afford and access globally accredited training materials, protocols, webinars, and as the chairperson of the Uganda Neonatal Steering Committee, I have also gained some authority helpful at district levels where only government ministry authority are often recognized,” she says, adding that “these political will and international commitments have encouraged us.”

She notes that knowledge exchange is a positive aspect of neonatal care in Uganda and that practitioners are eager to learn how to preserve these kids.

Nonetheless, she draws attention to the difficulty presented by medical schools’ scant teaching of neonatology, saying that “almost everybody in-service has to be re-trained to handle these babies, its a challenge, yet we have few trainers, few understand how to handle these babies, but opportunities are there.”Dr. Nakkeeto thinks these are chances to take advantage of, in addition to the personal network she has built over years of practice.

She also emphasizes the support provided by Dr. Diana Atwiine, particularly at the policy level, where she has taken the lead for neonatals. For instance, in the training of nurses, Dr Nakakeeto draws attention to the standard rotations that did not support their nationwide training, particularly because trainees were quickly transferred to other departments due to government policy, despite the hours spent on them handling cases in neo-natal.

Dr Nakakeeto indeed appears on the trajectory of neo natal progress in Uganda, and looks like she is not putting her hand off the plough.

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