Uganda - Health Projects

Adara’s Maternal Newborn Child Health (MNCH) work makes a significant contribution to ending the preventable deaths of women, children, adolescents, and in particular, newborns.

Despite the many gains made in reducing maternal and infant mortality across the globe, rates in low resource settings are still unacceptably high. In fact, 99% of all maternal and infant deaths occur in low-resource countries. Most could be prevented. The inequality in access to healthcare is devastatingly apparent.

The Adara Group was established two decades ago to benefit children, women and communities living in extreme poverty. Each year, we reach at least 50,000 people through service delivery and knowledge sharing. Over this time, Adara has gained deep experience and knowledge in MNCH. Over the next three years, we will take this experience and knowledge to address five key project components.

CENTRE OF EXCELLENCE IN MATERNAL AND NEWBORN HEALTH
  • Since 1998, Adara’s work has primarily focused on strengthening MNCH services in Central Uganda by supporting holistic programmes that ensure women and children have access to services across the continuum of care.

    With our partner Kiwoko Hospital, we have demonstrated the high impact of an integrated model of care that encompasses not just training and clinical support, but also ensures the hospital is equipped with adequate facilities, staffing, equipment and supplies – all the things it needs to provide high quality care.

    Kiwoko Hospital is a 250-bed hospital in Nakaseke district of Central Uganda serving 800,000 people. Together, Kiwoko Hospital and Adara have provided antenatal care, helped women deliver their babies safely, helped newborn babies needing specialised care in the neonatal intensive care unit (NICU), provided community outreach services and health promotion, and trained village health workers and clinicians from the local district health system.

NEWBORN HEALTH SCALE-UP
  • Adara plans to work with local champions of newborn health to continue contributing to the end of preventable newborn deaths in Uganda.

    The objective of our scale-up programme is to build national capacity in holistic newborn health by establishing training programmes for health providers working in newborn care, and establishing systems to resource health facilities with the equipment, supplies, medicines, and staffing required to save newborn lives.

    To do this, Adara has formed a newborn care leadership panel to increase momentum and energy around improving national policies, curriculum and clinical guidelines to save newborn lives. This panel will be an advisory and leadership group for Adara’s scale-up work.

    To test our approach, we are piloting a new newborn training programme at Nakaseke Hospital – a government hospital with limited resources. This programme will use a newborn care training manual that Adara is developing, paired closely with expert trainers. Nakaseke Hospital is geographically close to Kiwoko Hospital, and improvements to the quality of newborn care at Nakaseke could help relieve Kiwoko of some of the census challenges. As part of the programme, Adara will train Nakaseke clinicians in various health interventions designed to improve newborn mortality and morbidity, as determined by a needs assessment. We will provide recommendations for the required supplies, equipment, medicines, infrastructure and staffing ratios and will work with the leadership panel to assist the government with resourcing these.

SAFE BUBBLE CPAP PROJECT
  • Babies born before their lungs finish developing often struggle to breathe, panting in a helpless effort to take in enough oxygen. This is called respiratory distress syndrome (RDS), and without treatment it’s almost always fatal.

    The Safe Newborn Bubble CPAP Project will address the lack of access to safe and affordable treatment for RDS in low-resource settings. Adara has worked in partnership with the University of Washington and PATH to develop an inexpensive bubble continuous positive airway pressure (bCPAP) kit that does not rely on a power source and delivers a safe amount of oxygen for newborns.

    It is unlike most other CPAP devices available, which are either expensive and require electricity to run, or are improvised and untested and use a toxic amount of oxygen for newborns, raising the risk of blindness and long-term disability.

    Over a two-year period, we plan to train health workers and study the efficacy of this kit. The outcome will provide the evidence needed to produce and commercialise the kit for global scale to save hundreds of thousands of newborn lives each year.

EARLY INTERVENTION FOR HIGH-RISK NEWBORNS
  • It is challenging for a parent in the developed world to find the best resources for their child living with a disability. However, when the child lives in a community such as Nakaseke, Uganda, the lack of resources, social isolation and stigmatisation can severely impact the child and his or her family.

    In collaboration with the London School of Hygiene and Tropical Medicine and the Uganda Medical Research Council, Adara is partnering on a research study to help evaluate whether an intervention called the ABAaNA Early Intervention Programme can improve the quality of life for babies at risk of disability and their families. The programme provides a holistic solution to care for infants and improve their functioning. It also helps the parents gain more understanding and confidence.

    The study began in 2017 and will take two years to complete. After that, we will publish our findings. We are optimistic the results will provide hope and help to the millions of children living with disability in Uganda and across the world.

CRITICAL HEALTHCARE FOR FAMILIES LIVING IN CENTRAL UGANDA
  • Adara works with Kiwoko Hospital to reach some of the most vulnerable members in central Uganda, where 44% of people live below the poverty line and many do not have access to critical services. This includes people living with HIV, diabetes, disabilities, epilepsy, mental illness and tuberculosis.

    Adara will continue to support Kiwoko Hospital’s HIV, Diabetes, and Community Based Healthcare programmes to ensure vulnerable people have access to the services they need to survive and thrive.

HEALTH FACTS

  • Close to 3,000 women received care in the maternity ward in 2013

  • More than 2,000 babies were born in the maternity ward in 2013, 30% of which were delivered by caesarean

  • On average 24 nurses worked in the maternity ward each quarter in 2013

  • Close to 750 babies were provided life-saving care in the NICU in 2013

  • On average 23 nurses work in the NICU each quarter in 2013

  • 327 mothers practiced Kangaroo Mother Care in 2013, a technique of wrapping a newborn to their mothers chest

  • Close to 7,000 children have been immunised through outreach motherhood clinics in 2013

  • More than 5,500 people attended community antenatal meetings in 2013

  • 530 homes participated in sanitation competitions organised by the community based health care team in 2013

  • 899 adults living with HIV received medicines to treat opportunistic infections in 2013

  • On average 120 children are supported through Afaayo club (quarterly club for kids living with HIV)