Background Uganda continues to have a high neonatal mortality rate, with 20 deaths per 1000 live births reported in 2018. A measure to reverse this trend is to fully implement the Uganda Clinical Guidelines on care for mothers and newborns during pregnancy, delivery and the postnatal period. This study aimed to describe women’s experiences of maternal and newborn health care services and support systems, focusing on antenatal care, delivery and the postnatal period. Methods We used triangulation of qualitative methods including participant observations, semi-structured interviews with key informants and focus group discussions with mothers. Audio-recorded data were transcribed word by word in the local language and translated into English. All collected data material were stored using two-level password protection or stored in a locked cabinet. Malterud’s Systematic text condensation was used for analysis, and NVivo software was used to structure the data. Findings Antenatal care was valued by mothers although not always accessible due to transport cost and distance. Mothers relied on professional health workers and traditional birth attendants for basic maternal services but expressed general discontentment with spousal support in maternal issues. Financial dependency, gender disparities, and lack of autonomy in decision making on maternal issues, prohibited women from receiving optimal help and support. Postnatal follow-ups were found unsatisfactory, with no scheduled follow-ups from professional health workers during the first six weeks. Conclusions Further focus on gender equity, involving women’s right to own decision making in maternity issues, higher recognition of male involvement in maternity care and improved postnatal follow-ups are suggestions to policy makers for improved maternal care and newborn health in Buikwe District, Uganda.

Background Sub-Saharan Africa is the region with the highest neonatal mortality rate, with Uganda reporting 20 deaths per 1000 live births. The Uganda Clinical Guidelines (UCG) from 2016 have detailed descriptions on care for mothers and their newborns during pregnancy, delivery and the post-partum period. The objective of the study was to identify provider and user perspectives regarding the knowledge of and adherence to the UCG recommendations in aspects of delivery and newborn care, both in cases of normal as well as complicated births. Methods The study used qualitative methods with data collection from participant observations, interviews with key-informants and focus group discussions. Malterud’s Systematic Text Condensation (STC) was used for analysis. Results The study found low knowledge about the UCG among the health workers. Various discrepancies between performed hands-on-procedures and the UCG were found related to neonatal care practices, including low use of partograms, uncertainty around timing for cord clamping, routine oronasopharyngeal suction of newborns and inadequate implementation of skin-to-skin care. Conclusions Continued focus on systemic strategies for further implementation of the UCG is recommended.

Background: Sub-Saharan Africa is the region with the highest neonatal mortality rate, with 27 deaths per 1000 live births. The Uganda Clinical Guidelines (UCG) from 2016 have detailed descriptions on care for mothers and their newborns during pregnancy, delivery and the post-partum period, both in cases of normal as well as complicated births.Methods: The study used a qualitative method with data collection from participant observations, interviews with key-informants and focus group discussions. Malterud’s Systematic Text Condensation (STC) was used for analysis.Results: The study found various discrepancies between performed hands-on-procedures and the UCG related to neonatal care practices, including uncertainty around timing for cord clamping, routine oronasopharyngeal suction of newborns and inadequate implementation of kangaroo care.Conclusions: Continued focus on systemic strategies for further implementation of the UCG is recommended

Background: Uganda is a country struggling with reducing the neonatal mortality rate of 20/1000 live births reported in 2018 and to fully implement Ugandan clinical guidelines (UCG) on care for mothers and newborns during pregnancy, delivery and post-partum. This study aimed at describing maternal support systems including women’s access to and use of maternal health care and home support systems. Methods: Maternal support systems were investigated using qualitative methods including participant observations, semi-structured interviews with key-informants and focus group discussions with mothers. Malterud’s Systematic text condensation (STC) was used for analysis and Nvivo software to structure the data. Results: Antenatal care was valued by mothers and they relied on professional health workers and traditional birth attendants (TBA’s) for basic maternal services. General discontentment with spousal and family contributions in the postnatal period, financial dependency and lack of autonomy in decision making on maternal issues prohibited women in receiving optimal help and support. Postnatal follow-ups were found unsatisfactory. Conclusions: Further focus on gender equity involving women’s right to own decision making in maternity issues, higher recognition of male involvement in maternity care and improved postnatal follow-ups are suggestions for improved neonatal outcomes in Buikwe district, Uganda.

Background: Sub-Saharan Africa is the region with the highest neonatal mortality rate, with Uganda reporting 20 deaths per 1000 live births. The Uganda Clinical Guidelines (UCG) from 2016 have detailed descriptions on care for mothers and their newborns during pregnancy, delivery and the post-partum period. The objective of the study was to identify provider and user perspectives regarding the knowledge of and adherence to the UCG recommendations in aspects of delivery and newborn care, both in cases of normal as well as complicated births. Methods: The study used qualitative methods with data collection from participant observations, interviews with key-informants and focus group discussions. Malterud’s Systematic Text Condensation (STC) was used for analysis. Results: The study found low knowledge about the UCG among the health workers. Various discrepancies between performed hands-on-procedures and the UCG were found related to neonatal care practices, including low use of partograms, uncertainty around timing for cord clamping, routine oronasopharyngeal suction of newborns and inadequate implementation of skin-to-skin care. Conclusions: Continued focus on systemic strategies for further implementation of the UCG is recommended.