A SYSTEM-WIDE APPROACH TO MATERNAL HEALTH
We support consistently delivered, year-round healthcare services for pregnant women and mothers in our partner communities in southwestern Uganda. Our Omukazi Namagara Program -- run in collaboration with the local and district governments and grounded in the Ugandan Ministry of Health’s national goals and strategies -- is built around the following two objectives:
(1) Supply Side: Establishing a continuum of care across the antenatal, intranatal, and postnatal periods by bolstering the quality of local health centers and transforming the facilities into centers of excellence on which local community members can depend.
(2) Demand Side: Improving participation in maternal and neonatal health services by raising public awareness and establishing a Village Health Team program to bring community-based health services to the household level.
Through our services, we have:
Reduced home deliveries to under 20 percent in villages receiving PHP’s Village Health Team home visits. With this achievement, the ONP propelled our partner communities to meet the Ministry of Health’s target of at least 70 percent institutional deliveries several years early.
Nearly doubled fourth antenatal visits at the local health center. Indicating the completion of all recommended antenatal visits over the course of pregnancy, this achievement demonstrates our impact on the utilization of critical preventative health services.
Further extending our impact, we have carried out a rigorous research evaluation, generating important, policy-relevant evidence on maternal and neonatal health.
WHAT IS OMUKAZI NAMAGARA?
“Omukazi Namagara” is a phrase in Runyankore, the language spoken to southwestern Uganda, that means “the woman is life.” We have adopted this name for our program because women are the cornerstone of life in any society. Not only do women have lives of their own that must be cared for, but they also bring life into this world, and they sustain life by caring for children. By making sure that women and their children have access to quality healthcare, we support the future of the whole community and world.
THE OMUKAZI NAMAGARA MODEL
MORE ON OUR SERVICES: A CONTINUUM OF CARE
COMMUNITY-WIDE EDUCATION CAMPAIGN
We work with a team of nearly 30 PHP-trained Village Health Team members – residents of the local community who have stepped up to play a key role in improving the community’s health. These Village Health Team members carry out education talks on maternal and neonatal health in more than 100 villages. The health talks help to inform the whole community – pregnant women, men, women who may become pregnant in the future, the elderly, etc. – about recommended health practices during and after pregnancy and ways to support pregnant women, mothers, and newborns.
ANTENATAL CARE SERVICES IN HEALTH CENTERS
We make sure that quality services at local government health centers are consistently available. During a woman’s visits to the clinic, she is offered the following antenatal care services:
Health education on topics such as nutrition, delivery, and childcare
A physical examination
Folic acid and iron supplementation, de-worming medications, and malaria prophylaxis, as needed
An insecticide-treated bednet to prevent malaria
CONTINUED FOLLOW-UP VISITS BY COMMUNITY HEALTH WORKERS
Our Village Health Team members identify and visit pregnant women who have not yet accessed services at the health centers and conduct follow-up visits to women who have gone to the health center. Generally, each woman is visited about 3 times during the antenatal period. During the visits, the Village Health Team members provide personalized health guidance to each woman, make sure each woman has received proper care from the health center, check for danger signs and refer women to the health center if necessary, and help women prepare for delivery. Because the Village Health Team members live in the communities they serve, their work is integral to our service delivery and to bringing healthcare closer to the community level.
DELIVERY IN HEALTH CENTER WITH TRAINED SUPERVISION AND APPROPRIATE SUPPORT
Prior to the launch of the Omukazi Namagara Program a majority of women in our partner communities gave birth at home, raising the risk of maternal and child mortality. Our ultimate goal is for women to give birth in health centers or hospitals under trained supervision. Although this goal remains one of our greatest challenges, we aim to ensure proper deliveries first and foremost by improving the quality of care at the health centers. Along with the community and the government, we work to ensure that a midwife will be readily available whenever a woman goes into labor. We also ensure a consistent stock of delivery-related supplies at the health centers, meaning that women no longer have to purchase supplies beforehand. In addition, we provide health education to emphasize the importance of health facility deliveries, working with each woman and her partner to create a birth preparedness plan that accounts for any unique concerns or circumstances that they may have.
POSTNATAL FOLLOW-UPS BY COMMUNITY HEALTH WORKERS
Our involvement in the health of the families in Kashongi and Kitura does not end after delivery. Village Health Team members follow up with women and their newborns in the months following delivery to ensure that both the mother and child are healthy. Generally, the Village Health Team members make two postnatal visits, during which they provide health advice, check for danger signs, encourage women to attend all necessary postnatal visits, and work to ensure that newborns receive all necessary immunizations.
COMMUNITY-BASED DATA COLLECTION
When Village Health Team members visit a woman in her home, they record data on the health of the woman. At the end of every 3-month period, the Village Health Team members compile the data for all of the women in their villages. They then work together to compile the data for nearby villages and for Kashongi and Kitura Sub-Counties as a whole. After compiling data at different geographic levels, the Village Health Team members are able to view useful summary numbers on maternal and neonatal health. Through this system integrated into the community, we are able to translate patient-level information into public health indicators, which Village Health Team members are then able to use to assess the important health issues in their communities. Using this ongoing community-based data collection system, Village Health Team members can guide the priorities of future service delivery.