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Expanding Newborn Survival: Strengthening the NICU at Amai Community Hospital in northern Uganda

Introduction: A Critical Gap in Newborn Survival

Amai Community Hospital is a Private Not-for-Profit facility owned by the Church of Uganda, located in Amolatar District in Northern Uganda along the shores of Lake Kyoga and Kwania. The hospital serves an estimated population of 188,589 people and extends services to neighbouring districts including Dokolo, Kwania, Kaberamaido, and Nakasongola.

The hospital conducts a high volume of deliveries each month, and many newborns are born with complications that require specialised neonatal care. Before 2022, there was no Neonatal Intensive Care Unit (NICU), meaning critically ill newborns had to be referred to facilities more than 150 kilometres away. These delays contributed to preventable neonatal deaths along the referral pathway.

Why Newborn Survival Matters

Neonatal survival remains one of the most urgent global health priorities. The neonatal period, defined as the first 28 days of life, carries the highest risk of child mortality.

An estimated 2.3 million newborns die globally every year, with nearly 47 percent of all under-five deaths occurring within this period. Sub-Saharan Africa continues to record the highest neonatal mortality rates worldwide.

In Uganda, neonatal mortality is estimated at approximately 22 deaths per 1,000 live births. Most of these deaths are preventable with timely access to essential newborn care, including oxygen therapy, thermal regulation, infection management, and resuscitation services.

Reducing neonatal mortality is a key target under Sustainable Development Goal 3.2, which seeks to end preventable deaths of newborns and children under five, with a global target of reducing neonatal mortality to at least 12 per 1,000 live births.

Establishment of NICU Level I (2022)

In 2022, Save the Mothers East Africa, under the Mother Baby Friendly Hospital Initiative (MBFHI), established a Level I NICU at Amai Community Hospital to address critical gaps in newborn care.

The unit progressively served 165 newborns in 2022, 199 in 2023, and 367 in 2024. Despite this progress, the facility remained constrained by limited equipment, including one incubator and one phototherapy machine. This resulted in overcrowding, with multiple newborns sometimes sharing equipment during peak admissions.

The unit progressively served 165 newborns in 2022, 199 in 2023, and 367 in 2024. Despite this progress, the facility remained constrained by limited equipment, including one incubator and one phototherapy machine. This resulted in overcrowding, with multiple newborns sometimes sharing equipment during peak admissions.

Expansion to NICU Level II (2025)

In February 2025, Save the Mothers East Africa, in partnership with Uganda Christian University, upgraded the NICU to a Level II facility with expanded capacity and improved equipment.

The upgraded unit now includes three incubators, two phototherapy machines, one radiant warmer, two oxygen concentrators, and five oxygen cylinders. It can accommodate up to 10 newborns at a time, significantly improving the quality and safety of neonatal care.

The upgraded unit now includes three incubators, two phototherapy machines, one radiant warmer, two oxygen concentrators, and five oxygen cylinders. It can accommodate up to 10 newborns at a time, significantly improving the quality and safety of neonatal care.

Health workers and stakeholders share how the upgraded NICU is transforming newborn survival by providing lifesaving care closer to communities in Northern Uganda.

This video is placed here because it brings the intervention to life immediately after the technical explanation of the upgrade. It allows the audience to connect the system strengthening with real human experience before viewing outcomes and impact data.

Service Delivery Impact

Following the upgrade, the NICU now serves an average of approximately 25 newborns per month, significantly improving survival outcomes for premature and critically ill infants who previously faced high-risk referrals over long distances.

Admissions in 2025 demonstrate consistent service demand and improved access to care, with 16 newborns in February, 29 in March, 20 in April, 31 in May, and 17 in June. This reflects both the burden of neonatal illness in the region and the importance of strengthening district-level neonatal care services.

Human Impact Story

Among the families directly impacted are Juliet and her husband Ojok Sam. Their premature baby required urgent neonatal care immediately after birth and was admitted to the NICU, where lifesaving support was provided. The baby survived due to timely intervention, and the family describes the NICU as a lifeline that made survival possible.

Their story reflects the broader impact of strengthened neonatal services on families who would otherwise have faced devastating outcomes.

Overall Impact

The NICU expansion has contributed to reduced referral-related neonatal deaths, improved survival of premature and high-risk newborns, strengthened emergency newborn care capacity in Northern Uganda, and improved access to oxygen therapy, thermal care, and specialised neonatal interventions.

This intervention directly contributes to Sustainable Development Goal 3.2 and supports Uganda’s national efforts to reduce neonatal mortality and improve survival outcomes for newborns.

Conclusion

The transformation of neonatal care at Amai Community Hospital demonstrates how targeted health system investments can save newborn lives. By bringing specialised care closer to communities, Save the Mothers East Africa and its partners are reducing preventable deaths and strengthening the continuum of care for mothers and newborns in Northern Uganda.

By Teopista Agutu – Save the Mothers East Africa Communications & Networking Director