Our medical work in northern Uganda has evolved over the years. At its inception in 2010 we offered direct patient care and didactic sessions on topics requested by our Ugandan partners. We now are committed to a more sustainable train-the-trainer model. We utilize well developed programs from the American Academy of Pediatrics, WHO, JPIEGO (from Johns Hopkins), complete with program guides, participant and provider booklets, flip charts, posters, and exquisitely developed models of babies to be resuscitated and pregnant bellies to be delivered and monitored. These allow for excellent educational simulations.
Our current model is to provide training of these well developed programs (examples include Helping Babies Breathe, Essential Care for Every Baby and Bleeding After Birth) to midwives, clinical officers and skilled nurses who staff the local health centers in Aswa County. We then work together with our Ugandan medical colleagues to prepare them to train other health personnel, the goal being that anyone who may attend a delivery, care for a pregnant mother, or care for a newborn baby, have these essential skills.
- Ten skilled midwives, nurses and clinical officers have been trained to train others in Helping Babies Breathe and Bleeding After Birth
- The Ugandan trainers have trained approximately 120 health care workers staffing the 26 health centres in Aswa County in Helping Babies Breathe and Bleeding After Birth
- Additional trainings were provided in both curricula in 2019 to 40 newly hired staff
- Train 10 skilled midwives to train Pre-Eclampsia/Eclampsia and Essential care for Every Baby
- The Ugandan midwife trainers will then train both curricula to 120 health care workers staffing 26 health centres
- Facilitate ongoing practice in the skills of Helping Babies Breathe and Bleeding After Birth at each of the 26 health centres, eight weekly modules, one hour a week
In 2021, we hope to roll out training in a similar pattern in Threatened Premature Labour and Essential Care of the Small Baby.
We have distributed to all 26 health centres equipment to ventilate newborns , blood pressure cuffs, educational materials, thermometers and other supplies to promote safe deliveries and newborn care.
In 2017, upon the recommendation of Komakech Denis, a clinical officer within the government health system and medical coordinator of STEP-UP Uganda, we started a training program for over 200 village health workers and Traditional Birth Referral Agents (former Traditional Birth Assistants), noting that often they are the first, and at times the only, health care sought by some of the population. The emphasis was on the importance of their role within the community, even if they are not allowed to perform deliveries, utilizing that role to educate expectant families and encourage them to seek care from skilled health professionals in the health centres. We think this is very unique program.
We are in the process of developing a formal evaluation to better assess our impact. However the government medical system in Gulu has reported a drop in infant mortality which they attribute to STEP-UP’s educational activities. It has been requested that we facilitate similar interventions in neighboring Omora County, something that STEP-UP would like to make happen if substantial additional financial support became available.