Transitioning to Sustainable Development Goal 3: An intersectional approach examining maternal health policy in Uganda

Abstract

Background: Uganda is one the leading countries around the world which account for 60% of the total number of maternal deaths globally. Following the unsuccessful trajectory of MDG 5, no comprehensive research was conducted to determine why targets were not achieved, and maternal health priorities were reorganized under SDG 3. However, the efficacy of this approach remains uncertain. Methods: A meta-narrative review (MNR) provided insight into maternal health trajectories within Uganda prior to and during MDG 5, and informed the development of questions for key informant interviews. Interviews were conducted with 7 key informants to explore the development and implementation of maternal health policy in relation to MDG 5 and SDG 3. Thematic coding analysis was conducted using NVivo 12, in accordance with the criteria of constructivist grounded theory, to identify recurring themes. Findings: Four major themes were identified: i) the current narrative surrounding maternal health is deterring investment in SDG 3, ii) Uganda’s fragmented health care system impedes access to maternal health care, iii) empowerment issues among women, and iv) increased collaboration efforts are needed from Uganda’s government to improve maternal health outcomes. Implications & Contributions: Uganda has failed to advance women’s rights, as the government focusses on infrastructure development to drive economic development. However, Uganda will not progress if women continue to be oppressed and die as a result of its multifaceted maternal mortality crisis. Implications for maternal health policy: MDG 5 and SDG 3 were imposed on Uganda and do not necessarily reflect its best interests or its collective needs related to improving its maternal health outcomes. Striving to achieve SDG 3 would likely further oppress women and disadvantage the country overall. Thus, Uganda’s government must increase multisector collaboration to develop realistic and sustainable goals towards improving maternal health outcomes to better counteract its maternal mortality crisis.