Apr 18, 2018

Sport brings people together

football as a means of communication
football as a means of communication

“Sport brings people together, it encourages creativity and also attracts positive energy. It breaks deadlocks and develops natural talents and skills,” said Ocaka, a 17-year-old youth leader, from Unyama village.

 

Sport does more than this – it draws vulnerable young people to programmes where they can receive critical information and services.  This is particularly important in the Unyama community of Gulu, where many people lack access to health services and information.

 

The main issue, many youth in the community say, is that it is difficult to access the health system. Some women, for example, even resort to giving birth at home rather than going to health facilities. For the young people, there is lack of information on the best means of accessing healthcare. 

 

The Karin Medical Centre combines sport and information by working with a local football club in the community to offer information sessions and workshops on a variety of topics, including how to access health services, as well as sexual and reproductive health. For the young girls that are not able to continue with their education due to early pregnancy, the football club encourages them to seek proper health care specifically targeting them and their unborn child. 

 

A door to engagement

Football attracts young people. And these activities offer their own benefits, such as promoting health and social unity.  The right to play is even recognized in the Convention on the Rights of the Child, the most widely ratified human rights treaty in the world.

“The activities that I participate in during the youth sessions boost my self-confidence and perseverance and introduce me to new friends,” Ocaka told the team from Karin Medical Centre.

 

Karin Medical Centre is using sports as an entry point for spreading critical messages. During their sports sessions, the health team conducts information sessions that offer accurate, non-judgmental information on sexual and reproductive health issues.

Sport can also teach mutual respect, collaboration and conflict resolution – lessons that fit neatly into messages about human rights and peace building.

“It teaches the values of teamwork, fairness, discipline, respect for the opponent and the rules of the game, which can be translated into our everyday lives,” said Moses, the Laboratory Technician at the Karin Medical Staff.

Every month, the Karin team works with the young footballers to reach out to more youth in the community.  So far over 300 youth have been engaged in this network.

 

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Apr 18, 2018

Scaling down teenage pregnancy

teenage mother
teenage mother

Atim was lucky to have seen a midwife during her pregnancy. Many young teenage mothers in the community don’t.

“I felt very weak during my first trimester while I was pregnant, I hardly ate food, constantly sick and weak, but I did not know what to do. I had to go to the garden to weed my beans that I had planted with my husband,” she explained.  It never occurred to me that I could be in danger until one day I felt extremely weak and went to see the midwife,” she added. 

Atim was fortunate because she is under a voucher plus program that gives vulnerable expectant women subsidized maternity services. Under the program, she can attend four antenatal services, delivery and postnatal care, including family planning. Atim had been assessed by a local distributor who lives in the same village as her. When he realized that she was expecting a baby, he approached her and asked her a few questions. He encouraged her to start attending antenatal care at the Karin Medical Centre. Atim was very happy that this program exists.

“As soon as the midwife checked my blood pressure, she immediately said that I should be transferred to the nearest hospital. I was transferred to a hospital in an ambulance.” 

Atim does not want to talk much about this experience. It was very painful. The pregnancy ended in a miscarriage, but her own life was saved.  “I am still grateful for the emergency care I received, I am also still sad that I lost my child,” she said to the midwife.

 

Teenage pregnancy rates

While Atim’s story was tragic, it could have ended far worse. She was lucky to be seen by a midwife. Atim is also one of the many teenage girls that have dropped out of school due to early pregnancy.  

Uganda has the highest rate of teenage pregnancy in the Sub Saharan Africa region with 24 percent being pregnant or having a child before the age of 18. Uganda Bureau of Statistics also reports 63% of women give birth before the age of 20; the highest rate in the world (2016). Uganda also has the highest total fertility rate in East Africa, 6.2%. 

 

Scaling down teenage pregnancy  

Many tragic stories exist.  Too many young teenager girls are being forced into early marriages for material benefits expected by the parents.  In other instances, pregnancies are caused by rape.

Atim was encouraged to start family planning. And she is optimistic that it will work out well. And is committed to using family planning so that she can get her education before she having a baby.

“This time I feel good. I feel confident, I know how to not get pregnant,” she said. “And the midwife tells me to come back in case I have any complications with the family planning I have chosen.”

 

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Apr 18, 2018

Rural midwives help save mothers

mother
mother

“Just lie still and relax. Breathe slowly,“ midwife Diana guides Anena, age 24. Anena is attending her third antenatal care at the maternity centre for her third pregnancy. 

Diana pressed a fetal stethoscope onto Anena’s belly. “The heart is beating well,” she told Anena. Diana encourages all expectant mothers to attend at least four antenatal services. She works very closely with the community village health volunteers to identify expectant mothers who are then referred to the maternity centre. 

“It is important that we encourage the mothers to come to the clinic.  There is a misconception about the care that we provide at the health centre,” she explained. “The previous generation gave birth at home, most often with the help of a traditional midwife, who had no professional training. So sometimes they simply do not come to us,” Diana lamented. This makes it difficult to achieve one of our primary goals; reducing maternal mortality among the rural women. 

According to the most recent reports, the maternal mortality rate in Uganda has decreased from 438/100,000 women in 2011 to 336/100,000 women in 2016 during live births (Uganda Demographics & Health Survey 2016). Midwives have contributed tremendously to this decrease. Nearly three quarters of women (74%) now deliver with the assistance of a skilled birth attendant (UDHS 2016) compared to 37% in 2006 and 58% in 2011.

Midwives trained to meet rural needs

According to a United Nations Fund for Population Activities (UNFPA) policy brief, Uganda has about 1,043 midwives. Due to shortages of trained midwives, it is estimated that one midwife handles between 350 and 500 deliveries a year, yet the World Health Organization (WHO) recommends that a one midwife should handle no more than 175 deliveries a year. With an estimated 1,800,000 births per year (Country meters 2017) the country needs 9,243 more midwives to meet the required minimum staffing.  

Devoted midwives, poor infrastructure

Still, these midwives face a range of challenges while providing services– not only frequent power outages, lack of housing for midwifes on night duty, but also stock outs of supplies such as gloves.

In Gulu, the facility experiences frequent power outages and, because there is no standby generator, the midwives have to use solar power that sometimes does not work well during the rainy season, to light the maternity ward. “The current solar power is not enough to provide adequate light,” Diana explains. 

According to a study by WHO and the World Bank, lack of electricity remains a neglected barrier to effective provision of health services in many developing countries including Uganda.  A total 58% of health facilities in Uganda have no access to electricity, the study notes.

Grinding poverty also limits rural women’s access to care.

“They need to tend to their crops and take care of children,” Diana said, explaining that many women do not have the time or resources to seek health care.  Anena had to squeeze her check-up into a busy day of farm work. Afterward, she returned to the gardens, and also cared for her two young children.  “I have to meet my family needs by selling food at the market as well,” she said.

A role model

For her part, Diana says that, although she is sometimes overwhelmed with the workload, she is happy to see an increase in women seeking her services. She hopes to set an example for the next generation.  She too, grew up in the area, she explained. When she completed school in midwifery, she wanted to serve her community.

“I have some girls who want to talk to me about my education and some of the parents see that maybe it’s good for their daughters to stay in school. People see what I have done and so they have begun to think, maybe I can do that too,” she said.

 

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