NGO nurses Butaleja's weak child care services back to health (WORLD VISION)
Jul 23, 2015
The smile on 36-year-old Allen Mudida’s face as her son gets immunised and monitored for growth says it all.
By Richard Wetaya
The smile on 36-year-old Allen Mudida’s face as her son gets immunised and monitored for growth says it all.
The fact that she, like many other mothers in Butaleja district, can now easily access maternal and child health care services is, by all accounts, a welcome development.
The change in the health status quo in Butaleja, a district hitherto known for meagre maternal and child health indicators, has given mothers like Mudida and their children a new lease of life.
Mudida, a resident of Busibira parish in Butaleja sub-county, says unlike in the past, she now gets important and requisite maternal health, newborn and child health promotion services on time.
“Materials entailing prevention of mother-to-child HIV transmission, reduction of infant mortality, enhancing of hygiene and child nutrition, improving of perinatal, antenatal and post-natal health are provided on time,” she says.
According to Mudida, immunisation rates in the parish have risen since radical integrated community health outreaches took root.
“We had outreaches before, but they were never regular, compared to how they are now. Immunisation was the only service provided then,” Mudida says.
Lydia Wana, a 26-year-old mother of four and a resident of Namadete village, has also been a benefactor of the outreaches.
“Before the outreaches, I had to trek between 10km and 25km to access medicines, do blood tests and to get treatment for my children. Besides the immunisation drives, family planning counselling, HIV/AIDS prevention and safe delivery services are provided at the outreaches,” she says.
Wana says two of her children were malnourished, but they are now healthy because of the advice and medicine she got from health workers at the outreaches.
Such positive stories are just a fraction of the many that residents of Butaleja district are sharing about the Butaleja Maternal, Newborn and Child project. The project is running under the auspices of World Vision, with the support of the Republic of Korea, through the Air-ticket Solidarity Contribution (KOICA-Korea International Co-operation Agency).
Dr. John Matovu, the Butaleja district health officer, says the district is now enjoying maternal, newborn and child health coverage.
“World Vision has been a key and worthwhile partner in supporting improvements in district health service delivery. Integrated community outreaches have been existent, but with low functionality. With this project, old and new outreaches have been boosted. Our district’s maternal and child health care indicators have gone a notch higher as a result in just over one quarter,” he says.
According to Matovu, health services have been brought closer to the people in the villages and equipment has been delivered to many of their health centres to improve reproductive, maternal, newborn and child health services.
He says more mothers are delivering from health units.
Matovu says although the district has not hit the stipulated target of 65% deliveries under a skilled birth attendant, as required by the Uganda health sector strategic and investment plan 2010/11-2014/15, important inroads in that regard are being made.
Health centre-assisted deliveries under a skilled health worker in Butaleja were at 39% last year. This year, the deliveries have shot up to 57%, due to the good mobilisation by village health teams in the community. Rates of mothers using traditional birth attendants have drastically gone down in the district,” Matovu says.
Project objectives
Heechan Roh, the project manager, notes that their objective is to strengthen Butaleja’s health systems, with emphasis on maternal, newborn and child health.
“The project will be implemented in all the administrative units of Butaleja district. Our interest is radically improving maternal, newborn and child health in Butaleja, in partnership with other stakeholders,” Roh says.
Richard Muhumuza, the project’s co-ordinator for Butaleja, says the huge gaps and challenges in Butaleja’s health sector led to the interventions.
“The high maternal and child mortality rates and the low community awareness of maternal, newborn and child health services in Butaleja laid the foundation for these interventions. World Vision, with support from KOICA, is aiming at addressing the low access to maternal, newborn and child health services in the district, the low utilisation of maternal health services by pregnant women and the low community awareness and participation on maternal, newborn and child health services,” Muhumuza says.
He adds that in the four years the project is expected to run, efforts to increase the availability and service readiness of essential maternal, newborn and child health services in Butaleja and community awareness and acceptance of life saving interventions, will be stepped up.
Achievements
Muhumuza says the project has so far supported the district to train 1,225 village health teams (average coverage per village health team is 35 households) and also supported the establishment of 48 integrated outreach posts. This makes a total of 76 posts across 426 villages in Butaleja.
Muhumuza says the project is working with all health facilities in the district to enable them provide regular reproductive, maternal, newborn and child health services.
“As a means of enhancing child protection, 6,000 mama kits (package promoting clean births) and medical equipment, including weighing scales, stethoscopes, foetal scopes and vaccines carriers, were given out to health facilities within our catchment area,” he says.
According to Muhumuza, health management information systems have also been distributed in a bid to strengthen information sharing and capturing.
He adds that the project has improved access to and uptake of maternal, newborn and child health services in the district.
“This has been done through the strengthening and establishment of integrated outreaches. Referral processing through the provision of ambulances in conjunction with the private sector has also been strengthened,” Muhumuza says.
Challenges
Christine Oseku, the project’s community development facilitator, says the high expectations of some of the far-flung communities have, in some respects, hindered progress.
“Getting some communities to be on the same page with what the project stands for has been a tall order. In certain communities, the attitudes are not right and the demands have been excessive. We have also been hard pressed in fulfilling the project’s objectives in those very areas because people have been hard to galvanise and to convince. The high and untenable demands put on village health teams have, to some degree, dented the good rapport we had hoped to build,” Oseku says.
Sustainability
Matovu says the district community health system will remain strong, even when the project runs its full course.
“The district administration will ensure that there will be continuity in the initiatives after the project draws to a close. The village health training teams and the substantial knowledge they acquire from the trainings will remain with us,” he says.
Muhumuza says the health interventions will be sustained on account of the system strengthening implementation and capacity building measures they have undertaken.
“We are working with various stakeholders, like the district health team, both health and none health-implementing partners and the entire district to ensure mutual accountability and that the initiatives stay impactful, even when the project closes,” Muhumuza says.