Uganda has made progress in reducing maternal mortality, with rates decreasing from 336 to 189 per 100,000 live births, according to the 2022 Uganda Demographic and Health Survey. However, neonatal mortality rates have only slightly improved, dropping from 27 to 22 deaths per 1,000 live births between 2016 and 2022.

Neonatal conditions remain the leading cause of death in Uganda, accounting for 10.3% of all registered deaths in 2022. The leading cause of early neonatal deaths is birth asphyxia, responsible for 50% of cases, followed by prematurity complications at 18%, and septicemia at 7%, as reported in the 2022 Annual Health Sector Performance Report. In 2021, Save the Children Uganda, with funding from Save the Children Korea, established a well-equipped newborn intensive Care Unit at Karugutu Health Center IV.

Between November 2021 and March 2022, 28 newborns with respiratory distress were admitted at Karugutu HC. IV. Thirteen of them were referred for Continuous Positive Airway Pressure (CPAP) services at Fort Portal Regional Referral Hospital. Unfortunately, eight newborns died at the facility due to a failure to provide oxygen therapy by CPAP, attributed to a lack of equipment. Perinatal death audit reports highlighted the need for timely care and equipment.

 Karugutu HC. IV staff were often challenged by Neonatal Intensive Care Unit staff at Fort Portal Regional Referral Hospital for unnecessary referrals that could have been managed at Karugutu HC. IV. In March 2022, Save the Children, through the Health System Strengthening project, organized clinical attachments for all staff in the Newborn Care Intensive Care Unit at Karugutu HC. IV, which took place at Fort Portal Regional Referral Hospital for two weeks. Staff learned how to assemble an improvised CPAP using nasal prongs and normal saline bottles to care for newborns in need of CPAP.

From April 2022, after successfully completing the clinical attachment, 75 newborns with respiratory distress were admitted to the newborn intensive Care Unit of Karugutu HC. IV. Only five of these newborns were referred to Fort Portal Regional Referral Hospital, and only two of them died. This significant improvement in newborn care outcomes is attributed to the availability of locally improvised CPAP sets, which were introduced after staff returned from the two-week clinical placement at Fort Portal Regional Referral Hospital.