It's official--the first Safe Mothers, Safe Babies interns and practicum students have landed in Uganda! University of Texas students--Serena Rodriguez, Hitomi Hyashi, and Dara Schmitt--together with BYU students--Rachel Fisher, Ashley Larsen, and Hayley Heath--arrived Monday afternoon and Tuesday morning, and have headed out to Iganga to get started! A total of 24 students (including undergraduate, master's, PhD, and MD students) will be working on many projects, including:
eRanger Project
Description: In the summer of 2011, SAFE launched an “eRanger motorcycle ambulance” program at Ibulanku Health Center in Ibulanku, Iganga District, Uganda. A second eRanger is currently available for use in another SAFE project site, Lubira, but has not yet been launched due to some programming challenges that must first be overcome to ensure program sustainability and viability. Some activities in which the interns will participate include:
- Designing and carrying out a feasibility study in the Lubira catchment area to identify additional ways that the program can be sustainable by community members and health committee funds, to resolve current challenges, and to shape overall programming.
- Developing emergency response protocols (in consultation and with approval of local District Health Office and medical professionals), and training the health center staff that will be utilizing the eRanger on how to decrease barriers at each of the 3 delays model, how to improve response time, etc.
- Working with Emergency Clubs, specifically: (1) Collecting all reports from all clubs, and interviewing both providers and former patients about care rendered, needed training areas, etc. (2) Developing plan to incorporate the Clubs in the eRanger program (focusing on community sustainability). (3) Retraining Club members in First Aid and CPR, with emphasis on the subjects identified by interviewed individuals. (4) Developing a “train-the-trainer” model for Emergency Clubs (maybe identifying 3 or 4 individuals) so that training can occur on a more regular basis.
- Launching the eRanger program in the Lubira catchment area.
Data Collection and Survey
Description: SAFE regularly applies for grant funding, all of which is dependent on having high quality data
about the populations we serve. To add to our knowledge of the general area we serve and the effectiveness of our projects, our competitiveness in grant funding, and our ability to expand in the future, interns will assess specific projects and acquire up-to-date, extensive information about local health centers, hospitals, populations, infrastructure, and health capacity. Here is a sample of the activities that the interns will undertake:
- Assessing the impact of the SAFE-WE CARE Solar "Solar Suitcase" program, looking at both qualitative and quantitative indicators in both recipient health institutions and the populations they serve.
- Gathering the most recent District Health Surveillance Site reports and data for Iganga, Mayuge, Namutumba, Bugiri, Luuka, and/or Jinja Districts.
- Gathering the most recent Ministry of Health data on health centers in Uganda (number, location, size, population served, etc.).
- Gathering all health data, with special focus on maternal and neonatal health care services, from all area hospitals (special focus on Iganga District Hospital, Jinja Regional Referral Hospital, Bugiri District Hospital, and others as identified in-country).
- Visiting health centers in which SAFE has NOT yet worked but which might be feasible in the future. Emphasis on those health centers serving populations near Nsinze, Lubira, Ibulanku, or Naigobya. At each of these health centers, conducting a full assessment with heavy emphasis on both quantitative and qualitative data collection.
- Conducting focus group discussions regarding local definitions and understandings of maternal and child health. Emphasis placed on recording responses and documenting this process.
SAFE Mama Kits
Description: In the summer of 2011, SAFE implemented a grant from the Rotary International Foundation, part of which paid for the construction of 250 “mama kits.” These kits contain the basic supplies necessary for a clean, vaginal delivery; women are required to bring these supplies with them to the health center when delivering, otherwise they will be turned away and not allowed to deliver in that location. The kits purchased by the grant were given to Ibulanku Health Center to help overcome the barrier to care associated with women not having access to the needed supplies. The women delivering at the health center had the option to purchase the kit at a subsidized price during delivery, which was very successful. However, there were some challenges, namely that: (1) It was not entirely self-sustainable, as the grant purchase the initial supplies and the prices were subsidized considerably, (2) Distribution was limited to one health center, and (3) There was not community participation in the project to promote its uptake in the surrounding villages. To counteract these challenges, SAFE is piloting a project in which community groups MABEDA and BUBEDA will make and sell the kits to women in their villages, both to increase access to the kits and to promote income generation for the groups. Interns involved in this project might undertake the following activities:
- Training the groups in cleanly handling the supplies and assembling the kits (working with local medical professionals).
- Ensuring that all government requirements are meant for the distribution of a health product.
- Working with the groups to develop a training program for recipients to undertake when they purchase their kit (or generally, depending on community needs) that focuses on not opening the kit early, keeping the supplies clean, and the importance of cleanliness during birth (review the “6 cleans” handout from summer 2011 interns’ work).
- Working with the groups to solidify marketing and distribution activities and begin carrying them out in the community, with heavy emphasis on documenting through photos and/or video (preferably both if possible).
- Working with the groups on a financial feasibility and sustainability plan (budgeting, opening a bank account, etc.).
SAFE Media
Description: Media is an important part of SAFE’s ability to share our work and the wonderful people with whom we work, and this year, we will be seeking to not only share our work through photos and video, but also use photography and videography to change maternal health behavior. In particular, the Photo Voice Project (WE Share) will use photography to examine maternal and child health through the lens of the people in the community. Photos will be taken by rural men, women, and health care providers, then blown up and displayed in the community to promote discussion of maternal and child health, and used in U.S. gallery showings to stimulate discussion of pertinent subjects. Interns will:
- Train the rural men and women in photography and videography in participatory workshops.
- Issue "assignments."
- Review photos and create a plan to engage the community in discussion.
- Take photos themselves.
Save for Safe Delivery
Description: A major obstacle to women's ability to access care is lack of funds to pay for it (including eRanger transportation, as is required for that program to be sustainable). Working with several community groups, the SAFE Program Manager developed an idea to counteract these challenges called “Save for Safe Delivery,” in which women and their families would be encouraged to save a little bit of money every week from the time they learn they are pregnant in a small wooden box (like our piggy banks). Interns involved in this project will likely undertake the following activities (among others as identified):
- Working with women’s groups, men’s groups, community leaders, health center workers, and the SAFE Program Manager to flesh out the program design.
- Designing and conducting a feasibility study, identifying the best ways to help the communities develop, promote, and fund the activity.
- Launching the program.
Gnut and Nutrition Program
Description: Research has shown that nutrient fortified peanut-butter can help children recover from malnutrition with greater success than traditional foods such as rice and beans. Gnuts, which are akin to peanuts and locally grown in Uganda, could serve as a base for this type of supplementary food product. Last year, a community leader named Reverend expressed a desire to start a community-based gnut project. Since this is a crop that many families already grow, it would be within the realm of feasibility to have people in the community donate small amounts of gnuts to help create nutrient-fortified gnut butter for undernourished children in the area. This could possibly align well with the organic farming project SAFE is currently implementing with our community groups, as one of the crops the groups would like to grow is organic gnuts. Interns involved in this project will:
- Working with village leadership and civil society (especially KAMEDE Men’s Group) in the Lubira area, and with medical staff at Nsinze Health Center, to completely flesh out the project idea (using the New Project Proposal template), with emphasis on community sustainability and financial planning.
- Designing and conducting a nutritional needs assessment, with emphasis on understanding how malnutrition is affecting both child AND maternal populations (small scale assessments, within villages in the Lubira and/or Nsinze populations, possibly working with the Ibulanku Health Center to understand their procedures before undertaking our own study).
- Developing and conducting an engaging, participation-based training program in nutrition with local women’s groups, with emphasis on replication (so that the women’s groups could host a training workshop for other women).
Community Group MCH Activities Recording & Development
Description: SAFE works with several civil society organizations that conduct MCH-promotional activities in partnership with SAFE. These include dramas and songs that focus on maternal, neonatal, and child health, a safe motherhood home-to-home visitation program, and outreaches like those conducted on International Women’s Day. What we need most is to document all these amazing activities! The interns involved in this project will work extensively with these groups to understand their mission and record what they do, so that we can work with the groups more effectively in the future (to help them complete grant applications, to disseminate information about our impact, etc.). Examples of activities that might be undertaken include:
- Reviewing the constitutions, by-laws, and organizing documents of these groups, ensuring that these documents are in order (or helping them get ordered if not already), making copies (or taking pictures) of these documents, etc.
- Interviewing members about their activities in the groups, what has been most meaningful to them, etc.
- Attending outreaches, home visits, or drama/song performances. Not only recording these activities (and the number of people impacted), but also working with a translator to write down the lyrics in Lusoga and in English, so that an English-speaking audience can understand them.
- Documenting, documenting, documenting! Our goal is to be able to show how the community has taken on certain issues in their own ways.
- Gauging interest form the women’s groups in applying for an international grant to support their group. Assisting with grant proposal if the group is interested.
