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.
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.
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.
Progressive Health Partnership's Safe Motherhood Initiative now has a new name: the Omukazi Namagara Program. Literally translated from Runyankore (the language spoken in Southwestern Uganda) as "the woman is life", Omukazi Namagara not only illustrates the key role of a woman in the life of a family, community, and society but also illustrates the woman's ability to give life by fostering the growth of a baby.
PHP developed the new program title to better capture the purpose and components of the program. In recent months, PHP has created a significant postnatal emphasis within the program, which accompanies the program's already strong antenatal emphasis. Now the Omukazi Namagara Program will not only focus on taking steps during pregnancy to promote women's health but will also focus on taking steps after birth to ensure the continued health of the woman as well as the health of her baby.
PHP is also excited to report that it has hired two new Ugandan staff members to work on the program: Angella and Alex. Both Angella and Alex come to the team with computer science backgrounds, making a substantial contribution to the technical capabilities of the program. Angella, the assistant program coordinator, will focus on working with Village Health Team members, getting feedback from community members, and overseeing the electronic medical records system. Alex, the data manager, will work on collecting records and data through the medical records system as well as a survey of pregnant women. Together, Angella and Alex help demonstrate PHP's commitment to build more capacity within Uganda.
Although the start of the Omukazi Namagara Program has been delayed due to technical challenges related to the medical records system, the problems have been solved and the team is now preparing the software for real-life use. Among other tasks, the Omukazi Namagara team is currently preparing to train Village Health Team members, strengthen the services at the local health center in Kashongi, and implement the electronic medical records system. The team is excited for the months ahead and expresses its thanks for your continued support!
As they say in Uganda, Kurika Omwaka -- Happy New Year!
As we bring in the New Year, PHP is excited to report that the organization and its partners are gearing up for the launch of the Safe Motherhood Initiative in the coming months! After several months of preparation work, PHP is approaching the month of March, when it hopes to begin implementing the program in its partner communities, Kashongi and Kitura Sub-Counties in southwestern Uganda.
Currently, PHP is putting the final pieces of the project into place. First, we are excited to report that the electronic medical records system we will be establishing at the local government health center has recently been improved substantially; new features will now allow us to set up text messages that will automatically be sent to women at certain points during pregnancy to remind them of upcoming visits to the health center and to provide important educational content. We are excited to put these innovative features to use.
In addition to the medical record system, we are working to build further capacity by expanding and training the program staff in Uganda, strengthening our collaboration with both the local and district governments, and continuing to train members of the local Village Health Team to conduct an education campaign and make follow-up visits to pregnant women in their homes.
As always, we could not do any of this without your support. Thank you again for your generosity. We are very much looking forward to the start of the program and will continue to keep you updated on the progress!
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