By Brian Mugenyi
Mugenyijj@gmail.com
Kyanamukaka, Masaka: “Apart from the project of the road, we embarked on the health-care system, and that is Kyanamukaka Health Centre IV.”
It is a sentence that begins with development but ends with a question of life and death.
As Oscar Mutebi, a Private Secretary in State House, speaks about Kyanamukaka’s transformation, his attention turns from the newly improved roads to the people those roads are meant to serve.
His message to Government is direct: upgrade Kyanamukaka Health Centre IV into a hospital, strengthen maternity services and take primary health care closer to communities that remain distant from the facility.
“We are appealing to the Ministry of Health through Minister Chris Baryomunsi to upgrade Kyanamukaka Health Centre into a hospital or something else,” Mutebi said.
Then comes the statement that gives the health debate its human face:
“We have challenges that our mothers are giving birth on the floor.”
For Mutebi, this is no longer simply an infrastructure question.
It is a question of maternal dignity, emergency preparedness and the right of a woman to give birth safely in a health facility.
841 Deliveries—and a Facility Under Pressure
Kyanamukaka Health Centre IV is not an unused government structure.
It is a facility serving real patients and real families.
Uganda’s Annual Health Sector Performance Report for 2023/24 recorded 841 deliveries at Kyanamukaka Government facility during the financial year, alongside 1,774 admissions and 18,514 outpatient attendances.
The facility also recorded 108 Caesarean sections during the reporting period.
The numbers tell an important story: Kyanamukaka is carrying a significant maternity and patient load.
Put differently, the facility handled an average of about 70 deliveries every month during that reporting year.
That makes Mutebi’s call for expansion more than a political appeal.
It is a question of whether the infrastructure and services available can keep pace with the mothers arriving at its doors.
And there is historical evidence that the maternity burden has been persistent.
A Ministry of Health report recorded 15 deliveries at Kyanamukaka Health Centre IV in June 2014.
The health facility has therefore been a maternity lifeline for the community for years.
When Distance Becomes a Health Risk
Mutebi says Kyanamukaka Health Centre IV serves people from communities including Namirembe, Buyaga and the landing site.
For some residents, accessing government health care means travelling considerable distances.
“If someone is ill and transported a long distance from areas such as Namirembe, landing site, he or she might get complications as he is transported to the health centre since it is far,” Mutebi said.
For an expectant mother, the journey can be even more critical.
Labour does not wait for traffic.
An obstetric emergency does not wait for an ambulance.
And blood loss does not wait for a referral letter.
That is why Mutebi wants Government to establish Health Centre IIIs in Namirembe and Buyaga, while transforming Kyanamukaka Health Centre IV into a hospital.
“I appeal to the government to extend social services to them near, especially on the landing site,” he said.
31,521 People—and a Growing Question
The 2014 National Population and Housing Census recorded Kyanamukaka Sub-county’s population at 31,521 people.
That figure is historical and should not be mistaken for the area’s current population, but it provides a useful picture of the scale of the community that has depended on local public services.
The wider question is simple:
As communities grow, can health infrastructure remain frozen at yesterday’s capacity?
For Kyanamukaka, Mutebi believes the answer should be no.
He wants a stronger hospital-level facility at the centre of the community, complemented by lower-level health facilities closer to residents.
Ssekandi Takes the Matter to the Health Ministry
The appeal has also found support from Edward Kiwanuka Ssekandi, former Vice President and Presidential Special Envoy.
In a special letter addressed to Dr Chris Baryomunsi, Ssekandi congratulated him upon his leadership of the health sector and drew attention to Kyanamukaka Health Centre IV.
He called for immediate attention and additional resources to improve services for patients and mothers.
“I want to congratulate you upon your achievement as the Health Minister and I want to remind you that Kyanamukaka Health Centre IV needs immediate health attention and extensive resources to help the sick and delivering mothers with good health services,” Ssekandi said.
Mutebi says Ssekandi’s connection to Kyanamukaka goes beyond politics.
“Ssekandi is one person who fought for Bukoto Central to be what it is. He has helped the place, left active politics, and today when you engage him, he still takes Kyanamukaka at heart,” Mutebi said.
The Road Is New. The Health Challenge Is Not.
Kyanamukaka has recently witnessed infrastructure improvements, including the tarmacking of the Kyanamukaka Town Council road.
For residents, the road is expected to improve mobility.
For pregnant women, it can reduce the difficulty of reaching health services.
But a road has limits.
A tarmacked road can shorten the journey. It cannot provide a maternity bed.
It can carry an ambulance. It cannot replace a doctor, midwife or theatre.
It can bring a patient to the health centre. It cannot supply the blood, medicines or equipment required during an emergency.
This is the heart of Mutebi’s argument: development must be connected.
Roads must lead to functioning health facilities.
Health facilities must have the capacity to receive patients.
And mothers must be able to give birth in dignity.
“Kyanamukaka will never be the same again,” Mutebi said.
The Ward Is Where the Promise Is Tested
Public health is ultimately measured at the point where policy meets the patient.
For Kyanamukaka, that point is the maternity ward.
It is the expectant mother arriving in labour.
It is the newborn taking its first breath.
It is the health worker making a decision under pressure.
It is the family hoping that the government facility near them has everything necessary to save a life.
That is why the 841 deliveries recorded at Kyanamukaka in 2023/24 matter.
They represent not merely a statistic, but 841 moments when mothers entrusted their lives and those of their babies to a public health system.
The challenge now is to ensure that the system is ready for them.
Mutebi’s proposal is therefore clear: upgrade Kyanamukaka Health Centre IV into a hospital; strengthen maternity and emergency services; and establish Health Centre IIIs in Namirembe, Buyaga and other underserved communities, including the landing site.
The Ministry of Health now faces a public-health question that Kyanamukaka cannot answer alone:
Can Uganda’s investment in health infrastructure move beyond counting facilities to ensuring that every facility has the capacity to deliver safe, timely and dignified care?
For Kyanamukaka, the answer could determine whether the area’s development story becomes a story of buildings—or a story of lives saved.
Because development is not complete when the road is tarmacked. It is complete when the mother who travels on that road reaches a health facility where she can safely deliver her child and return home.
