We Are Healthy and Happy: Caring for Mothers and Babies in Uganda

When Sarah got pregnant again after losing her first baby to miscarriage, she was scared. But Holt Uganda’s prenatal and mother and infant health program changed everything — supporting her to have a healthy pregnancy, and a healthy, happy baby girl. 

In rural Uganda, having a baby isn’t always safe. And it isn’t always certain.

While maternal and infant mortality rates have significantly decreased over the past ten years, the risk is still considerable. Every day, about 300 infants and 20 mothers die from preventable causes in Uganda. The rate is even higher among mothers and infants in rural areas.

Twenty-four-year-old Sarah knew the risks when she got pregnant with her first baby. She prayed she would have a healthy pregnancy. But at three months pregnant, she lost her baby to miscarriage.

She later learned from a doctor that this was possibly due to frequent urinary tract infections, stress and malnutrition – conditions that likely could have been prevented with the right medical care.

“I did not attend any antenatal checkups,” Sarah says. “I wish I had at least attended antenatal [appointments] to receive prenatal supplements. I wouldn’t have lost my baby…”

Lack of Prenatal Care in Uganda

In rural Uganda, many pregnant mothers like Sarah don’t have access to prenatal care. They’re prone to infections due to lack of sanitation, and many are malnourished – a condition exacerbated by pregnancy.

The result is dangerous for both mothers and their babies.

“I did not attend any antenatal checkups. I wish I had at least attended antenatal [appointments] to receive prenatal supplements. I wouldn’t have lost my baby…”

Infant, child and maternal mortality in Uganda is mainly attributed to the “three delays” — the delay in making the decision to seek care, delay in reaching a health facility in time, and delay in receiving adequate treatment. Many mothers want medical care, and even know they need it, but the nearest clinic is often a many-hours walk away, and too expensive for women living in poverty.

But one of Holt’s biggest initiatives in Uganda is to provide nutrition and health services to children living in poverty, and this begins as early as possible. Proper nutrition in the first 1,000 days of a child’s life — from conception to around 2 years old — is critical.

“Early intervention is key,” says Emily DeLacey, Holt’s director of nutrition and health services. “Malnutrition during the first 1,000 days can cause irreparable damage to a baby’s developing brain and body.”

To achieve this goal, Holt has to reach women early in their pregnancies with the medical care and resources that could help them overcome the odds — both for their babies and themselves.  

Health Days for Pregnant Mothers

Through the support of sponsors and donors, Holt Uganda is equipped to provide essential medical care and nutrition to women and children in the rural communities where they work.

But although they have the resources, this work is not without hurdles.  

The first hurdle Holt Uganda has to overcome is reaching mothers who live in these rural, underserved areas. To do this, they have trained up village health workers — local advocates trained in basic health and nutrition practices — to go door-to-door in their communities, screening mothers for malnutrition, offering resources and education, and encouraging prenatal medical care and nutrition.

Then, every quarter, sponsors and donors also make it possible for Holt Uganda to host Child Health Days — reaching over 150,000 children and 5,000 pregnant women each year! At these community-wide events, children receive malnutrition screenings, deworming tablets, vitamin A supplements and more. Pregnant mothers receive malnutrition screenings, too, as well as anemia screenings and critical prenatal vitamins and iron supplements as needed to help them have a healthy pregnancy.

“These prenatal vitamins have enabled mothers to give birth to healthy and vibrant babies,” says Julius Magezi, Holt Uganda’s program manager. “We’ve heard stories all over the communities that we serve, that they have helped women become healthy, have safe pregnancies, and reduced maternal and infant mortality.”

Safe, Healthy Pregnancy in Uganda

These basic services to mothers alone have had huge results. Most powerfully, every mother Holt Uganda has been able to help thanks to sponsors and donors has survived pregnancy and childbirth. Because when a mom is well nourished during pregnancy, it makes a profound difference for her baby for years to come.

“Good nutrition for moms during pregnancy can prevent multigenerational cycles of malnutrition,” Emily says. “It allows their babies’ organs, immune system and metabolism to fully develop, ensuring babies start their lives with everything they need to grow to their fullest potential!”

Now, women don’t have to feel scared or alone when they learn they’re having a baby. Instead, they know there’s a team of people who can help them stay healthy, and go on to have a healthy baby.

This was the exact outcome for Sarah, who learned she was pregnant again just a couple months after her miscarriage.

A Healthy Baby Girl

“I immediately spoke with a Holt village health worker who talked to me about nutrition and caring for the pregnancy,” Sarah says about the first weeks of her pregnancy. “She also discussed with me the benefits of giving birth at the health center, and attending eight prenatal visits.”

A village health worker visited Sarah at her home and assessed her nutrition status by measuring the circumference of her upper arm. After determining that Sarah was at risk for malnutrition, she referred Sarah to a local clinic where she received prenatal vitamins.

“When I started taking them,” Sarah says, “my energy was boosted. [The clinic] encouraged me to eat small but frequent meals, including nutritious snacks.”

Sarah felt better with the additional nutrients and attended each of her prenatal visits through all nine months of her pregnancy.

Then, in June 2023, she safely delivered her baby girl at the health center.

Postpartum Support for Mothers and Babies in Uganda

In the months before giving birth, Sarah had attended classes from Holt Uganda about the importance of breastfeeding. She learned techniques to support successful breastfeeding, which she began for her daughter right away. This helped Sarah to heal post-delivery, kept her baby from getting sick and ensured she received the exact nutrition she needed to grow!

“When mothers are well nourished,” Emily says, “they are able to grow healthy babies and ensure their essential breastmilk is meeting all of a baby’s needs to grow strong and resilient to infections and illnesses.”

Sarah continues to receive visits from village health workers, who check on her recovery and her baby’s growth. And they’re doing great!

“Thankfully, my baby has now made six months of exclusive breastfeeding and my nutrition status is normal,” Sarah says. She’s started introducing solid foods to her daughter, which she says she loves! Sarah says she can’t wait to see her continue to grow big and healthy.

“My baby and I are healthy and happy,” Sarah says, “thanks to Holt Uganda!”