Causes of Maternal Mortality in Uganda: Legal, Socioeconomic, and Healthcare Perspectives
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Date
2025-05-29
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Uganda Christian University
Abstract
This study examined socio-economic and legal determinants of maternal mortality in Uganda focusing on the effectiveness of existing healthcare policies and insurance coverage among women. The study was motivated by the persistence of high maternal mortality levels despite Uganda's adoption of multiple legal systems with a goal to improve maternal well-being. The study sought to assess the legislation that governs maternal health, analyze the role of socioeconomic determinants in maternal deaths, and discuss the effect of healthcare policies in Uganda. A mixed-methods study design was used, with the reliance on secondary data from Uganda's national health surveys and legal frameworks, and logistic regression was utilized to assess the relationship between maternal death and socio-economic determinants. Multiple harsh gaps and inequalities in maternal services were revealed in the findings of the study. On legal frameworks, whereas policies exist, such as the Uganda Constitution (1995), the National Health Policy (2010), and the Uganda Vision 2040, the implementation level is low. On socio-economic determinants' contribution, the research showed that levels of education were a strong determinant of the risk for maternal mortality (e.g., odds ratio for women who were not educated = 5.511, p = 0.000). Wealth status was also significant, with the poorest women being at higher risk of death from pregnancy-related causes (odds ratio = 1.575, p = 0.000). Age was also a significant predictor, with women aged 45–49 years having the highest risk (odds ratio = 13.601, p = 0.000). Health insurance coverage was drastically low, with less than 5% of women under health insurance, and few were reported to be aware of their maternal health rights. In general, the study calls for the strengthening of the enforcement of current legal frameworks, the improvement of access to maternal health services, and the narrowing of socio-economic inequalities. Policy recommendations include increased investment in the infrastructure for maternal health, prepping more skilled birth attendants, and bringing maternal health coverage into national health insurance plans. Practical Recommendations include road enhancement and emergency care provision. Areas found lacking in research include longitudinal outcomes studies and more research into cultural and institutional determinants of obstacles to maternal care. Keywords: maternal mortality, legal context, socio-economic status, health care policy,
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Keywords
legal context, socio-economic status, health care policy, insurance, Uganda, logistic regression