Thursday, August 30, 2018

STARS Project to access a Continuum of Care enables delivery of healthy babies

By Esther Nakkazi

Twenty-three-year-old Edisa Nanteza is heavily pregnant and beyond the 9 months, she is already at term. She has also had some signs like lower back pain, a bloody vaginal discharge to show that the child is about to pop out.

Nanteza delivered her two older children aged 5 and 3 years at the Traditional Birth Attendant (TBA) and without her ever attending antenatal clinics. But for this third delivery, she is willing to change and deliver from a health facility.

She has learned a lot from the village health worker, Jacent Nakasujja, who aggressively monitors her and she evidently sees mothers with healthy babies in her community that have been born in health facilities.

Nakasujja works with the Grand Challenges Canada funded Stars project as a Community Health worker also called Village Health Team (VHT) in Uganda.

The Stars project on Reproductive, Maternal, New-born and Child health is implemented in Kibaale and Hoima district in midwestern Uganda by Malaria Consortium and is funded by Grand Challenges Canada.

“For the first two deliveries, I lost a lot of blood. The TBA put salt on the umbilical cord of the second baby and it developed a nasty infection,” says Nanteza for the reasons she wants to switch and deliver from a health facility.

What has also jerked Nanteza to go and have this child delivered under the watchful eyes of a skilled health worker are the constant SMS reminders she and her husband Ronald Kyeyune receive on their phones.

As a result of these reminders, she has her ‘delivery bag’ ready to go with all the necessities required for giving birth in case of an emergency.

The SMS are sent out reminding community members about different activities and to remind pregnant women and their husbands about attending antenatal visits. They particularly target men because their response is key in decision making for the health of their families.

Some of Nanteza’s profound fears about delivering from a health facility have been allayed by the VHT. She had a conversation with friends who narrated rude health workers and harrowing tales of survival.

The Malaria Consortium Stars project has trained the midwives and other health workers on how to handle clients at health facilities. “These days they are friendly and disciplined,” Nakasujja assures and that puts Nanteza in warm and caring hands.

Nanteza has also heard from another friend, Jackie Kabaseke, that she got all the services at the health facility with no hassle. “My friend told me when she gave birth the baby was immunized the next day and she spent only two days at the health facility and got discharged,” says Nanteza.

Her friend has only been back to the hospital to treat intense backache pains for which she was given painkillers and to have her bouncing baby immunised.

“During my pregnancy the village health worker visited my home and told me that I have to have four check-ups (antenatal) before birth, deliver in a health facility, maintain good hygiene, sleep under a mosquito net and eat a balanced diet and more so eat green vegetables so I planted them around my home,” says Nanteza’s friend.

She was educated about safety steps during pregnancy like attending at least four antenatal visits at 3, 4,6, 8 months and educated about the importance of antenatal, postnatal care, immunization, prevention of malaria during pregnancy and HIV prevention.

Many women suffer life-altering injuries and die during childbirth or their newborns fail to survive because basic issues that are inexpensive are not adhered to, important information is not passed on and there are no constant reminders or someone to check up on them.

Some luckily give birth without incident but for those who get seriously injured or never come home with their babies the situation can be better with an improved continuum of care from the community to the health facility.

Nanteza has heeded to what she has learned from the VHT who has been aggressively monitoring her and her friend’s good advice - to deliver from a health facility - because there are benefits for both mother and newborn. So this third child will be her first.

It was during one of her routine visits that Nakasujja found Nanteza still at home even though she already had all the labor signs at play. She immediately told her the urgency of going to the health facility with not a minute to waste. The two of them in tow picked up her already packed a delivery bag and traveled the long distance to Nyamarwa Health Centre III.

It is certainly with the VHTs intervention that Nanteza has ended up at the health facility and not the TBA to deliver this third child, says Stella Bakeera-Ssali, the project officer Stars project, Malaria Consortium.

The long line winding with pregnant women waiting to be attended to by Sister Jane Namakula, an enrolled midwife at Nyamarwa Health Centre III had to accommodate Nanteza. But she was lucky, Nakasujja was at her side and explained the urgency of the situation which gave her priority access.

“We have to detain her and monitor her because she is already at term,” says Sister Namakula. “We also can't let her go back home because she lives far away from the health facility and that could be another excuse for not delivering her baby from here,” says Namakula.

As the VHT leaves the health facility she is sure to check on a happy mother with a healthy newborn because she is in well-trained hands of the health worker.

This Story was facilitated by the STARS project of the Malaria Consortium Uganda

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