Table 2.
Selected national and SMGL Districts Indicators before Interventions
| Characteristic | Uganda | Zambia |
|---|---|---|
| National Indicators | ||
| Life expectancy at birth (male/female) (2012)a | 56/58 | 55/58 |
| Health Expenditures | ||
| Total expenditure on health as % of GDP (2011)a | 9.3 | 6.2 |
| Total expenditure on health as % of general government expendituresa | 10.1 | 16.4 |
| SMGL 4-District Indicators | ||
| Area (sq. km) | 10,851 | 49,468 |
| Population (2011)b | 1,750,000 | 925,198 |
| % of Population in rural areas | 84% | 61% |
| Women of Reproductive Ageb | 342,060 | 193,515 |
| Expected Live Birthsc | 78,261 | 37,267 |
| Type of Health Care Facilityd | ||
| Health Posts | 19 | 16 |
| Health centers without surgical care | 72 | 91 |
| Health centers with surgical care | 8 | 0 |
| District Hospitals | 7 | 6 |
| Regional Hospitale | 1 | 0 |
| Facility Ownershipf | ||
| Government | 65 | 106 |
| Private for profit | 11 | 0 |
| Private not for profit | 31 | 7 |
| Emergency Obstetric and Newborn Care (EmONC) Facilitiesf | ||
| Comprehensive EmONC | 7 | 4 |
| Basic EmONC | 3 | 3 |
a GDP Gross Domestic Product. Source: World Health Statistics, 2014
bBased on the district-wide census of the population conducted in 2013 in Uganda (4 districts) and in 2012 in Zambia (4 districts) and projected back to 2011 [31]
cEstimated by summing the expected births in each age group (number of women of reproductive age from district-wide census multiplied by their age specific fertility rates from 2011 DHS) in Uganda and by applying 2010 Census crude birth rates in Zambia
dHealth facilities providing delivery care prior to SMGL [29]
eFort Portal is the regional referral hospital located in Kabarole district; it has 351 beds and serves the entire Ruwenzori region constituted of 3 SMGL-supported districts (Kabarole, Kyenjojo, Kamwenge) and 4 non-SMGL districts (Kasese, Ntoroko, Kyegegwa and Bundibujyo)
fEmONC includes a set of life-saving interventions (aka “signal functions”) that the World Health Organization has recommended to reduce maternal and neonatal mortality (WHO, 2009). Basic EmONC interventions include administration of parenteral antibiotics, uterotonics, or anticonvulsants; manual removal of placenta; removal of retained products; assisted vaginal delivery; and basic neonatal resuscitation. Comprehensive care interventions include two additional services: ability to perform obstetric surgery (e.g., C- section) and blood transfusion. Facilities were classified based on whether they had, within the previous 3 months, performed each of these interventions. Because assisted vaginal delivery—using either forceps or vacuum extractor—is relatively uncommon in both Uganda and Zambia, some facilities were classified as fully providing EmONC care even if they did not perform assisted vaginal deliveries within the past 3 months (EmONC-1)
Note 1: in Uganda, district and regional hospitals and health centers with surgical capacity (health centers IV) are designated as CEmONC facilities, able to perform each of the 9 signal functions and serving about 100,000 population [27]; in Zambia, only district and higher level hospitals are designated to provide CEmONC care [28]
Note 2: Unless otherwise noted, the figures in the table are numbers