Progressive Health Partnership

Progressive Heath Partnership fights with all its power to eliminate the burden of disease on the global poor and to eradicate the inexcusable inequalities that divide our world. We listen closely to the poor, we learn from them, and we join together with them in common cause to build real solutions to the problems they face.
Mar 7, 2013

Omukazi Namagara Program continues to grow

PHP staff conduct a focus group discussion.
PHP staff conduct a focus group discussion.

Greetings to everyone from Uganda, where Progressive Health Partnership is continuing to make strides in its Omukazi Namagara Program!  PHP was excited to welcome a new member of its team to Uganda just a couple weeks ago.  Claire Prieto, who will serve as a Project Associate for the next year, represents a great addition to the Omukazi Namagara Program.  Claire brings to PHP previous experience working in Uganda, as well as expertise in community development and maternal health.  Her experience working on malnutrition programs will be a great asset to PHP as the organization aims to strengthen the nutrition-focused components of the Omukazi Namagara Program.

The addition of Claire to PHP's staff represents the organization's continued growth and the success of the ONP.  In her role, Claire will also work on preparing for the expansion of the ONP.  PHP has large ambitions for the program.  The top priority we hope to address is saving the lives of women and children at birth.  In particular, we hope to establish ambulance services for women during labor.  Further down the road, we are considering the feasibility of constructing an operating room within Kashongi and Kitura, so the communities can handle complicated cases themselves, and women are not forced to travel long distances to receive decent healthcare services.

Implementing any of these ideas requires significant resources.  But we know we'll get there, and it's thanks to you that we are able to do the work that we do.

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Nov 29, 2012

Omukazi Namagara Program addresses urgent problems

Woman at health center with ONP education posters.
Woman at health center with ONP education posters.

As you know, PHP recently launched the Omukazi Namarara Program, thanks to the generous support from all of you.  I'm pleased to be able to report that the program is continuing to go very well.  The people in Kashongi and Kitura, our partner communities, have fully endorsed the new services, and we're laying a strong foundation for the future as we aim to improve maternal and neonatal health.

Despite the progress, we're still far from solving all of the maternal and neonatal health issues in Kashongi and Kitura.  In this message, I'd like to share a story with you which I feel provides a good illustration of the enormous problems we're up against.  I think that those of us who are interested in eliminating maternal and neonatal health disparities can learn much from this story.  The story follows.

One day a woman, who I will call Jessica (who has given me permission to tell her story), arrived at the government health center in Kashongi to give birth.  She was 17 years old and had been working as a maid for a wealthy family in the community.  This was her first pregnancy, and she had just had her first antenatal visit about one week ago.  She was one month premature, and her membranes had ruptured before labor.  The midwife instructed her to go to the Mbarara Regional Referral Hospital, located about 45 minutes away by car, because she could not handle the case.

The man who had impregnated Jessica had left her.  She was completely alone at the health center.  Her family lived about 30 minutes away by car, and she had no way of communicating with them.  With the little money she had, she paid a motorcycle driver to visit the family she had been working for and ask for help.  The family told the motorcycle driver that they were completely finished with Jessica and had no interest being involved in her life.

Jessica stayed behind the health center, in pain, at times laying in the grass and at times standing with her arms folded -- scared, ashamed, and lonely.  My colleague and I had a car, so we decided to take her to Mbarara.  On the way, we picked up her mom.  When my colleague went to the family’s home, her mom hesitated, complaining that she had just been in Mbarara with her own sick baby, and now she did not have a single shilling.  My colleague assured her that we would handle the costs, and she then came quickly.

As one reaches Mbarara, the first thing he or she will see is Lakeview, a huge luxury hotel.  Most people from “the village” -- that is, the rural areas -- never come to Mbarara.  I could only imagine what Jessica and her mother were thinking as we drove into the city.  I always knew a significant disparity existed, but this occasion put it into stark relief for me.

When we reached the hospital, we brought Jessica to the admitting doctor on the obstetrics ward.  “Do you have a plastic sheet?” were the first words out of his mouth, referring to one of the many supplies women themselves were expected to bring for their deliveries.  He then told us that there were no beds left in the antenatal room, so Jessica would need to sleep on the floor and would therefore need a mattress.  As Jessica and her mom got “settled”, my colleague and I left to buy a mattress and sheets.

When we returned, her mom was holding a sample of blood that had been drawn from Jessica.  They were waiting for us so they could figure out what to do with it.  We spoke to the doctor, and he said that a complete blood count and a blood smear to test for malaria were needed.  The hospital did not do those tests, we learned, so we would need to take the sample to a private lab.  I asked whether the doctor could use the Poor Patients Fund, which I knew was available at the hospital, to cover the cost.  He responded that the Poor Patients Fund was only available on the medical ward and that the obstetrics ward was predicated on “survival of the fittest.”

We first took the sample to a discounted lab affiliated with the hospital that was located on the same grounds.  But we were turned down because the lab’s machine was broken.  We then drove the sample to a private lab in the middle of town and received the results within about an hour.  At this point, if not earlier, a poor person from the village would have been utterly lost.  Mbarara was like a foreign country to them, with many people speaking English and a completely different way of life.  Moreover, the class differences between the health workers and the villagers were striking.

We brought the test results back to the hospital.  It appeared that Jessica had a bacterial infection, but a doctor would not be available to interpret the results until the next day.  When I visited Jessica the next morning, she still had not given birth.  The ordeal had now been going on for over 30 hours.  I began to lose hope.  I asked a nurse to please make sure she was taken care of, and I left for work.  I returned in the evening; miraculously, I found Jessica and her newborn baby.  They were doing well, all considered.

In addition to showing the paucity of basic public health services in Uganda, Jessica's story shows what it is like to navigate the healthcare system as a poor patient.  With all of the obstacles poor people have to confront, virtually every element of the system is stacked against them.  These are the kinds of problems that PHP is working to address.

Jessica was extremely fortunate, but other women are not as lucky.  There is no reason why, in the 21st century, so many women should continue to die from childbirth-related causes and so many children should have to grow up without mothers, all because of simple, solvable problems.  PHP is exerting all of its power to implement solutions to these problems -- because accessing decent healthcare should not be the monumental challenge that it currently is for the poor.

As we enter the holiday season, let's be thankful for everything that we have and make commitments to support the betterment of people's lives elsewhere.  PHP continues to deeply appreciate all of your generous support toward this end.

Mosquito nets at health center installed by PHP.
Mosquito nets at health center installed by PHP.

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Aug 17, 2012

Omukazi Namagara Program begins!

Training of community health workers.
Training of community health workers.

Greetings from Uganda!  Progressive Health Partnership is happy to announce that the Omukazi Namagara Program (ONP) was officially launched last month in Kashongi and Kitura Sub-Counties in southwestern Uganda.  The program consists of three primary components: (1) improved provision of antenatal and postnatal health services at local government health centers, (2) an education campaign on reproductive and child health by community health workers, and (3) home visits to pregnant women and mothers by community health workers.

Before the start of the ONP, PHP decided to nearly double the number of community health workers participating in the program, from 14 to 26.  This step has helped to build more capacity within the community and will allow the community health worker team to cover a greater number of women with increased attention.  In June, PHP program facilitators carried out a one-week training of the expanded team of community health workers, utilizing many programmatic materials and tools that had been months in the making.

Currently, the health education campaign, which has reached hundreds of men and women throughout the community, is coming to a close.  The community health workers are now beginning to focus exclusively on their home visits.  Through the home visits, they will not only be advising pregnant women and mothers on their health and the health of their babies, but they will also be collecting and compiling data so that they themselves can analyze the health problems in their villages.

PHP has also taken steps to improve the quality of care at the local health centers.  By outfitting the beds at the health centers with mosquito bed nets, purchasing equipment such as complete delivery kits, and ensuring that the health centers have appropriate supplies and medications, PHP hopes to both improve the working environment for the health workers and make the facilities ideal locations where women can give birth.  So far, the response from the community has been very positive.  Over the coming months, PHP will be working to gauge the effects of the program and to identify areas for improvement.

Thanks to your generous support, we have already been able to take these steps to address maternal and neonatal health in our partner community, and we look forward to building on these achievements as time goes on.

Community health worker during training.
Community health worker during training.
Health education talk.
Health education talk.
Women during health education talk.
Women during health education talk.
Health education talk.
Health education talk.

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