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Il caso Uganda - Prima le mamme e i bambini - Medici con l’Africa Cuamm
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Il caso Uganda - Prima le mamme e i bambini - Medici con l’Africa Cuamm

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Roma, 15 dicembre 2012 - Medici con l'Africa Cuamm presenta il progetto "Prima le mamme e i bambini - I primi passi: risultati, innovazione e ricerca". Nelle slide la presentazione del caso Uganda.

Roma, 15 dicembre 2012 - Medici con l'Africa Cuamm presenta il progetto "Prima le mamme e i bambini - I primi passi: risultati, innovazione e ricerca". Nelle slide la presentazione del caso Uganda.

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Il caso Uganda - Prima le mamme e i bambini - Medici con l’Africa Cuamm Il caso Uganda - Prima le mamme e i bambini - Medici con l’Africa Cuamm Presentation Transcript

  • Mothers and Children First: The case of Uganda Peter Lochoro MBChB, MSc Country Representative Doctors with Africa CUAMM, UgandaPrima le mamme e i bambini 15 dicembre 2012 II caso Uganda
  • Uganda – Oyam District Prima le mamme e i bambini 15 dicembre 2012 II caso Uganda
  • PL1
  • Diapositiva 3PL1 Explain the diagram and the Italian version Peter Lochoro CUAMM Uganda; 15/12/2012
  • PL2 Signal Functions for Emergency Obstetric and Neonatal Care, Oyam District Aber Hospital is the only health unit which provides all 9 signal functions. Therefore it is qualified as comprehensive emergency obstetric care (CEmOC) None of the health centres provide all 7 signal functions to qualify as Basic Emergency Obstetric Care (EmOC) The most missing signal function is “Assisted vaginal delivery (i.e. use of vacuum extraction, forceps) Instrument used: Need assessment of emergency and neonatal care, Columbia University, AMDD 2011. Prima le mamme e i bambini 15 dicembre 2012 II caso Uganda
  • Diapositiva 4PL2 Need to explain HC 1-6 and diagram Peter Lochoro CUAMM Uganda; 15/12/2012
  • Quality of maternal and neonatal care, Aber Hospital .Instrument used: Assessment tool for the quality of hospital care for mothers, newborn and child, WHO 2009. Prima le mamme e i bambini 15 dicembre 2012 II caso Uganda
  • Quality of maternal and neonatal care, Aber Hospital Substantial improvements necessary to prevent serious risk to the health of mothers and new borns.`Issues: Sick newborn care, nursery, Guidelines, protocols, auditing: Improvements necessary to avoid risks for the health of mothers and new bornIssues: 1. Organisation: Infrastructure, equipment, supplies, laboratory, access, HIS. 2. Clinical: Maternal care (normal delivery and obstetric complications) Neonatal care (routine), Mothers and newborn follow- up Improvements necessary to mininmize potential risks for the health of mothers and new bornIssues: Drugs availabilityPrima le mamme e i bambini 15 dicembre 2012 II caso Uganda
  • Equity Aber Hospital, Oyam District 77% of women who delivered at Aber Hospital belong to the richest quintile, while none belong to the poorest quintile 40% of women who delivered at health centres belong to the richest quintile, while 10% belong to the poorest quintile Instrument used: Proxy Wealth Index, Demographic Health Survey Uganda 2006.Prima le mamme e i bambini 15 dicembre 2012 II caso Uganda
  • Indicators of Emergency Obstetriccare, Oyam District Acceptable Indicator standard Oyam 1a. Number of cEmONC facilities 1 1 1b. Number of bEmONC facilities 3 0 2. Proportion of all births in EmONC facility None set 12.4% 3. Population based caesarean section rate 5-15% 2.4% 4. Direct obstetric case fatality rate in EmONC <1% 1.5% facility 5. Intrapartum and very early neonatal death rate None set 2.8% in EmNOC facility 6. Proportion of maternal deaths due to indirect None set 33.3% causes in EmONC facilityPrima le mamme e i bambini 15 dicembre 2012 II caso Uganda
  • Conclusion• The project is beginning to get results• Now we are more knowledgeable about the gaps in quality, equity, coverage and we have a basis for specific actions for improvement• Gaps in Signal functions for EmONC persist and we need to address them; esp. assisted vaginal del, use of anticonvulsant, to get HC IV fully functional• Quality gaps are mainly in Sick newborn care, nursery, Guidelines, protocols, auditing:• We are not yet serving the people we intend to reach Prima le mamme e i bambini 15 dicembre 2012 II caso Uganda