Closing the Mother and Baby Loop of Care

The ISIS Foundation and Kiwoko Hospital recently rolled out Phase 2 of the Community Based Healthcare Programme. Phase 2 will work to ensure the hospital’s expertise in maternal, infant and child health reaches more women and children in the community, breaking down barriers to accessing healthcare.

Ugandan Family

BY DEBBIE LESTER, ISIS Clinical Programmes and US Country Director

At long last, after many months of researching, deliberating and planning, I am so happy to announce that Phase 2 of the ISIS Foundation/Kiwoko Hospital Community Based Healthcare (CBHC) programme has begun. We hope that many lives will be positively impacted by this programme and that barriers to accessing healthcare will be removed for residents of the Nakaseke District.

In 1998, when ISIS began working in Nakaseke (formally Luwero), we began our work in the community, building the CBHC hall at Kiwoko Hospital. However, upon witnessing the devastation suffered by families as a result of high neonatal and maternal mortality, ISIS focused efforts on newborn and maternal survival within the hospital.

At that time, the hospital staff had no paediatric or newborn training, so the first step was building a comprehensive neonatal intensive care programme. We know that in order to give a child the best chance at survival, care of the mother is of the upmost importance. So in 2008, we began working in maternal health with the hospital, rebuilding an entire wing including a new neonatal intensive care unit (NICU), labour and delivery ward, and maternity unit.

Our long term goal has always been to complete the mother and baby loop of care and continue where we began so many years ago – in community based healthcare. A few weeks ago, those dreams because a reality when the training for the new programme began.

Side by side with community leaders, Kiwoko Hospital, Dr. Margaret Nakakeeto and district health officers from government clinics we share a common goal to serve mothers and their children and provide access of care at all levels – a basic human right.

The current CBHC programme works in 44 villages and provides sanitation and hygiene programmes, maternal and infant care through various safe motherhood initiatives, immunization clinics, disability services, epilepsy support and school programmes on adolescent health (with a focus on menstruation hygiene management). Our goal with Phase 2 of the CBHC programme is to deepen and expand maternal, infant and child health initiatives in the current villages the programme serves. 44 Village Health Team members (VHT) have been identified, baseline research collected, and training began a few weeks ago.

Utilizing guidelines from the Ministry of Health, the VHT’s will work with families to teach the importance of seeking and attending antenatal care, pregnancy related health education, the importance of seeking a skilled attendant at birth, encourage safe, facility delivery, recognition of early dangers signs in pregnancy and what to do. The VHT’s are volunteers and are the community’s initial healthcare contact. In the first year each VHT will target at least 10 mothers each to teach these lifesaving lessons. All training will take place at Kiwoko Hospital to strengthen the link between community and facility.

Next, all clinicians (approximately 100) and leaders from 18 Health Centres in the district will attend 5 days of training at Kiwoko Hospital taught by experts in the field of maternal and infant health. At the end of the training these clinicians will have the opportunity to do work alongside an experienced nurse in both the NICU and Maternity wards at Kiwoko hospital to further increase knowledge and continue strengthen the facility and community bonds. Pregnancy, delivery & newborn services are offered at various levels of Health Centres in the district, and it is critical families have access to a skilled attendant. The Health Centres are often the first facility a mother attempts to access when seeking care related to pregnancy and delivery. This training will help upskill the health centre clinicians so that they have a better understanding of maternal and newborn health, to help save more lives.

Debbie and MosesOnce Phase 2 is underway and implementation is in progress we will evaluate subsequent phases of the programme. The ISIS Research, Monitoring and Evaluation team will be collecting information and evaluating all levels of training as the various programmes are rolled out to make sure the training is effective and that the programmes are having the desired impact.

During my visit to Kiwoko in May we put the final pieces of the programme in place. The energy, enthusiasm, and dedication of the team was palpable. I will continue to keep our followers posted on our progress as we walk this journey together.

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