AOGU in partnership with USAID RHITES

Increasing utilization of maternal and neonatal health services is one of the focus areas for USAID/Regional Health Integration to Enhance Services (RHITES) in South West Uganda.

USAIDRHITES SW enlisted the Association of Obstetrician and Gynecologists of Uganda (AOGU) along with its partner professional association; the Uganda Paediatrics Association (UPA) to conduct the training of 50 health workers in Basic Emergency Obstetric and newborn care. In addition, AOGU will provide professional recommendations on how to develop and sustain quality MNCH services in the RHITES region.

The USAID RHITES SW project is providing support to 15 districts with the main goal of increasing utilization of health services, by strengthening systems, improving quality of services, increasing availability of, access to and demand for quality services, and supporting the health sector to sustain higher service utilization rates. The southwestern region has been epidemiologically characterized to have poor maternal and neonatal health indices. According to the UDHS 2011, the region recorded the 2nd highest perinatal mortality rate of 48/1000. According to the Annual Uganda Health Sector Report of 2014/15, skilled birth attendance was lowest in Buhweju (25.1%) Mitooma (28.8%) and Rubirizi (32%) closely followed by Ntungamo (43.9%), Isingiro (47.5%), Ibanda (48.9%) Kabale (49.6%)and Kanungu (52.1%). An analysis of the site specific data also revealed higher numbers of neonatal and maternal deaths in these districts. At service delivery level, there is a shortage of human resources with the right knowledge, attitude and skills contributing to poor quality of the service delivery. For instance, While 20-50% of births in south-western Uganda happen in facilities, it is estimated only 12% happen at

facilities with full BeMONC/CeMOC capacity. This causes a delay in accessing these services even when one has reached the facility.

As part of implementing the project activities and under MNCH support, USAID RHITES SW project strives to improve the competences of human resources through conducting capacity building activities for health workers from public and private-not-for-profit health facilities. The purpose is to equip frontline health workers with requisite knowledge and skills as well as attitudes/values to appropriately care for the mother and newborn during pregnancy, delivery and the immediate postnatal period, as part of a continuum package of care. In addition, the project strives to strengthen health systems especially in areas of Quality of care improvement, especially in use of partographs for labor monitoring; Routine care of the newborn as well as care of the sick newborns; Infection prevention practices; Record keeping, documentation of care, data collection and utilization of collected data for quality improvement

The initial phase of the capacity building initiatives targeted high-volume health facilities in 7 districts in Southwestern Uganda (which facilities also had the worst performance indicators in this area). The seven priority districts include Kanungu, Isingiro, Mitooma, Buhweju, Ntungamo, Rubirizi and Ibanda. Training focused on Basic Emergency Obstetric and Newborn Care (BEmONC), and needed to be followed up with facility-based mentorship to reinforce knowledge, skills and attitudes for emergency maternal and newborn care.

Objective of the training and follow-on post-training mentorship

The objectives of the follow-on mentorship were listed as follows:

  1. To equip health workers with hands-on skills in order to enhance their ability to deliver quality services for mothers and newborns, particularly at the time of delivery. The expected outcome is to update participants’ knowledge, skills and values in the identification and management of obstetric and newborn emergencies and complications that lead to maternal and newborn morbidity and mortality.
  2. To ensure that the health workers provide sustained quality health services in the target health facilities in order to reduce maternal and neonatal mortality and morbidity, thereby causing improved survival in the region
  3. To create a pool of skilled healthcare providers from within the districts to support ongoing facility level mentorship at lower health facilities.