Mothers and Children First:                The case of Uganda                   Peter Lochoro MBChB, MSc                  ...
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                 ...
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...
Quality of maternal and neonatal      care, Aber Hospital          Substantial improvements necessary to prevent   serious...
Equity Aber Hospital, Oyam                    District                                                         77% of wome...
Indicators of Emergency Obstetriccare, Oyam District                                                                 Accep...
Conclusion• The project is beginning to get results• Now we are more knowledgeable about the gaps in  quality, equity, cov...
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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.

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

  1. 1. 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
  2. 2. Uganda – Oyam District Prima le mamme e i bambini 15 dicembre 2012 II caso Uganda
  3. 3. PL1
  4. 4. Diapositiva 3PL1 Explain the diagram and the Italian version Peter Lochoro CUAMM Uganda; 15/12/2012
  5. 5. 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
  6. 6. Diapositiva 4PL2 Need to explain HC 1-6 and diagram Peter Lochoro CUAMM Uganda; 15/12/2012
  7. 7. 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
  8. 8. 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
  9. 9. 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
  10. 10. 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
  11. 11. 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

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