By Bazio Doreen.

At seven months pregnant, Anzoa knows that getting an ultrasound scan is not simply a matter of visiting the nearest health facility.

In this complex account representing the experiences of women in Adjumani, a pregnancy scan can mean finding money for transport, travelling long distances and, sometimes, making the journey to Adjumani General Hospital because the service is not available closer to home.

For an expectant mother, distance can become more than an inconvenience. It can delay information about a pregnancy and, where complications are present, delay decisions about referral and treatment. Adjumani District is now trying to address that gap by moving the technology closer to the women.

The district has received five portable Point-of-Care Ultrasound (POCUS) machines to strengthen antenatal care and help health workers detect pregnancy-related complications earlier.

The machines, handed over on October 5^th, 2026, were provided through the Ministry of Health under the Pathfinder International EMPOWER Programme, with funding from the Government of the United Kingdom through the British High Commission.

The five machines are worth approximately Shs 100 million, while another Shs 40 million has been invested in training five health workers to operate them.

The solution is straightforward: instead of expecting every pregnant woman to travel to where an ultrasound machine is available, portable equipment allows the service to move closer to communities.

Solving the distance problem.

Adjumani has 43 high-volume health facilities, according to Medical Superintendent of Adjumani General Hospital, Dr Michael Ambaku.

He says the concentration of ultrasound services at the district hospital has placed a burden on women who live far from the facility.

“Currently, mothers have been highly burdened to travel long distances to Adjumani General Hospital,” Ambaku said.

The five beneficiary facilities are: Adjumani General Hospital, Mungula Health Centre IV, Ofua Health Centre, Ukusijoni Health Centre and Ayilo Health Centre III.

The facilities were selected based on the number of mothers they serve. This is important because access to maternal healthcare is not only about whether a service exists. It is also about whether a woman can reach that service in time and at an affordable cost.

Uganda’s 2026 EMPOWER assessment found that facility deliveries have increased from 60% to 86%, but maternal mortality remains at 189 deaths per 100,000 live births. Neonatal mortality stands at 22 deaths per 1,000 live births, compared with the global target of 12.

The assessment identified persistent barriers including distance, cost, shortages of trained personnel and gaps in quality of care.

The Adjumani intervention therefore addresses one piece of a much larger puzzle; building on what is already working. The new machines arrive at a time when Adjumani has recorded notable improvements in maternal health.

A district report covering July 2024 to May 2025 recorded 13,577 deliveries, of which 13,575 were safe, with two maternal deaths. Officials attributed the achievement to interventions including Birth Preparedness and Complication Readiness (BPACR) and Maternal and Perinatal Death Surveillance and Response (MPDSR).

Adjumani General Hospital had also been ranked third among more than 63 government general hospitals nationally for low mortality rates. The figures suggest progress, but health officials say the work is not finished.

Adjumani District Health Officer Dr Dominic Drametu says prenatal deaths require more attention. He hopes the new machines will enable the district to conduct outreaches and monitor pregnancies in neighboring facilities.

“It is my hope that with these machines and the trained health workers, we shall embark on health outreaches to be able to monitor fetuses in neighboring health facilities,” Drametu said.

From equipment to a functioning solution. The strongest part of the intervention is that it does not stop at the delivery of equipment. Five health workers are being trained, and specialist mentors from Mengo are providing hands-on mentorship to the trained POCUS users.

This matters because medical equipment can only improve outcomes when health workers know how to use it, the machines remain functional and patients can access the service.

The district will therefore need to track more than the number of scans conducted. It will need to know: How many pregnant women are being scanned at the five facilities? How many high-risk pregnancies are being identified? How quickly are women with complications referred? Are the machines functional throughout the year? Are trained health workers consistently available? And are women in remote and refugee-hosting communities actually benefiting?

These indicators can turn the intervention from a successful equipment handover into a measurable maternal-health solution. A model that could be taken further

Dr. Daniel Kamya, Pathfinder International Regional Coordinator for Northern and Eastern Uganda, said the intervention followed engagements between the British High Commission, Ministry of Health and Adjumani leaders after gaps in antenatal care were identified.

The portable machines are intended to support scanning at health facilities and during referrals, while mentorship will continue after the initial training.

This approach offers a potentially useful model for other underserved districts: identify a specific service gap, take the appropriate technology closer to communities, train the people who will use it and continue mentoring them.

For Adjumani, the next step is making sure the model works beyond the launch day.

The District Chairperson, Ambayo John Anyanzo, has urged health workers to put the equipment to good use, while calling for additional investment in medical equipment.

For women like the composite Anzoa, the measure of success will not be the number of machines delivered or the value of the investment. It will be whether she can walk into a nearby health facility, receive a timely scan, learn whether her pregnancy needs special attention and, if necessary, be referred before a manageable complication becomes a crisis.

That is where the real value of bringing the ultrasound closer will be measured.

END.