LIFE FOR MOTHERS | REDUCE THE NUMBER OF WOMEN AND INFANTS THAT DIE DURING PREGNANCY/CHILDBIRTH

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What We're Doing

ESSENTIAL COMPONENTS

Family Planning (FP): Educating men and women regarding FP options and increasing their accessibility to such options. These include condoms, as well as long-acting and permanent methods of contraception, such as IUDs and tubal ligation.
Prevention of Mother-to-Child-Transmission of HIV (PMTCT): Through increased screening and regular follow-up with patients who are taking ARVs.
Continuum of Care: Care and support for mother and child throughout pregnancy and the first month of a child’s life.
Deliveries and C-Sections at the Health Center (HC): To reduce risk of death and complications, such as obstetric fistulae.
Education: To encourage male participation, empower women, and improve health literacy regarding child survival, FP, HIV, etc.
Empowerment: Closely tied to education of men and women, as women in rural Uganda are required to get their husbands’ permission before seeking care.
Transportation: Currently there is no reliable/safe mode of transport to the HC.
Incentive: The project will increase demand for these services by incentivizing women and men with vouchers and/or conditional cash transfers.

HUMAN RESOURCES AND TRAINING

Health Professionals and Community Health Workers
LfM will engage civil society by training local residents to become community health workers (CHWs), who will then provide education and service delivery. Initially, LFM will recruit and train 50 CHWs, scaling up to 300 during the first year.

At the present time there are only nine health professionals at the HC, none of whom is a physician. Midwives perform all deliveries without anesthesia. Medical officers, who are able to perform Caesarean sections and provide long-acting and permanent methods of contraception, will be recruited as staff for the facility. Additional nurses and midwives will supplement existing staff to provide 24/7 coverage.

Training
The project director will coordinate the training of CHWs with multiple partners, including the World Health Organization, the Ministry of Health, and the Local District Government of Mityana . Training will include maternal/neonatal/child health issues, family planning strategies, HIV testing and treatment options, male partner involvement in pregnancy and the role of gender equity in women’s health. With this training, CHWs will deliver a wide array of critical services that are currently almost non-existent, including:

Screening for medical/infectious diseases
Distribution/delivery of condoms, medications, immunizations, etc.
Identification of high-risk pregnant mothers
Ante/post-natal tracking of mothers and infants
Counseling women and men on family planning options

mHEALTH TECHNOLOGY
One of the core aspects of the LfM initiative is the use of mobile phone technology to track health data in real time. By linking CHWs through a cell phone network using mHealth applications, LfM can tackle the communication gap between patients in the community and staff at the HC. This will also enable the collection and transmission of health data in real time and the delivery of care in the field. Additionally, real data (not statistical estimates) will give LfM and policy makers the chance to modify interventions over time and constantly improve health outcomes.

THE NETWORK
The importance of creating a delivery network for healthcare services to increase individuals’ access to better healthcare cannot be overstated. Because of poor infrastructure in rural Uganda, it is essential to provide healthcare through an outreach strategy. Specific benefits of an established network include:

Systematic recording of births and deaths
Collection of baseline prevalence of infectious diseases/other health indicators
Transportation to the facility for both routine and emergency visits
Reliable delivery of medications and immunizations on a timely basis
Repeated screening for HIV and STDs during pregnancy for expectant mothers and their male partners.

After one year, the data collection will enable LfM to determine which interventions were efficacious in reducing morbidity and mortality.
By offering counseling and various services in the community rather than at the HC, LfM will not only increase screenings and service delivery, but also reduce costs and travel.

COMMUNITY PARTICIPATION
The role of the community in this project will be to reinforce the activities of the health professionals and CHWs through increased awareness of why maternal health matters to every Ugandan. The project director will work with some of the same agencies providing CHW training to develop lectures and workshops for the broader community. Key issues to be addressed include:

Cultural factors such as HIV and related stigma, gender inequity, and gender-based violence, high fertility rates, male partner involvement
Basic health literacy, such as for testing and treatment of STDs and other infectious diseases, giving birth in a health facility with a skilled attendant present, etc.
Family planning education emphasizing condom usage and long-acting and permanent methods of contraception.

Lastly, the project director will partner with the district parliamentarian to enlist community elders, church leaders, and community council members as advocates for family planning, male partner involvement, and lowering fertility rates.