ADDRESSING HIGH INFANT AND MATERNAL MORTALITY IN KAMULI

Addressing High Infant and Maternal Mortality in Kamuli District

This project proposal is addressing the High Infant and Maternal Mortality Rates in Kamuli District of Uganda.   There is lack of a model healthcare service delivery that is comprehensive and well integrated to address the health needs of the women in form of a well packaged service.  It is common to find that women due to delivering have nothing for the pain, no clean beddings or a scalpel to cut the umbilical cord and no team of nurses and doctors to monitor the blood pressure or the baby’s heart rate,” the reason why for every 100,000 live births in Uganda, about 505 women die of complications related to pregnancy and child birth annually.  Of these, 20 – 30 more will suffer short term or long term disabilities (ruptured uterus, fistula or pelvic inflammatory disease).  While the infant mortality as measured in 2010 in Uganda was found at 63 children per 1,000 live birth, the figures estimated for Kamuli district are relatively worse than the Uganda average.  The fertility rate in Uganda is amongst the highest in the world at 6.7 children per woman on average. Knowledge about reproductive health decisions remains low, as a result women’s productivity is compromised both by the amount of time required for giving birth and looking after children as well as the risks women face in giving birth with inappropriate health care. 

The solution is to address the factors that are responsible for the High Infant and Maternal Mortality Rates in a comprehensive way; these are difficulties in accessing health facilities, socio – cultural considerations and poverty, through the vehicle of targeted Behavior Change Communication (BCC) intervention under the umbrella of Self Help Groups (SHGs).  The project will motivate the beneficiaries by engaging in guided dialogue about a specific issue, they are likely to build confidence in their ability to practice the desired behavior.  The project will use BCC is part of an integrated, multilevel, interactive process that will develop and tailor comprehensive messages and approaches using a variety of communication channels to target communities.  It will aim at fostering positive behavior change and maintain it.  The proposed intervention package targets to reduce maternal death by 75% as well as infant mortality by using Behavioral Change Communication (BCC) together with Interventions to include empowering women in skills acquisition as well as Self Help Group initiatives as a vehicle out of poverty; introduce vouchers for reproductive health services, boost the welfare of staff to enhance their morale, use of ICT and telephone services, patient reach-out, mobilization and advisory services.

The innovation in form of Behavioral Change Communication (BCC) together with Interventions to include empowering women in skills acquisition as well as Self Help Group initiatives will have impact given that during the intervention particular attention will be given to the targeted audience and the design of messages and adopt approaches that will achieve the desired results.  There will be consistence in message delivery, this together with education and skill training of the women and getting them to form Self Help Groups as a vehicle in fighting will empower women to earn income to be able to command a better standard of living as well as counter problems in accessing health services due to lack of money to afford health services and meeting transportation costs to access the health unit.  Out of the income generated, the women members will be able to subscribe and periodically pay into the Vouchers for reproductive health services so that as one when one needs a medical service, she will not need to look for cash to get treatment.  This package when off ground will show positive tangible results which will induce sustainability as well as keep attracting new members to subscribe.  The innovation will significantly impact the development challenge as poverty will greatly be addressed through the empowerment of women when they become members of Self Help Groups (SHGs) which will help to see them involved in income earning, hence reverse the current dependence on men.  The subscription to the Voucher system will mean that women members will have made savings into the scheme such that on falling sick or when in need of maternity services; they will just proceed to the health facility for medical attention which has not been the case.  The BCC will impact on use of family planning methods and smaller families as well as the need to use professional medical practitioners.