Day 2 panel 2 mo c helass ss_ug 108032

1. Mother and Child Health Lacor, South Sudan
(MoCHeLaSS)- Learning how to implement integrated,
community-focused reproductive and child health PHC in
post-conflict settings
Elijo Omoro Tahrir, Emmanuel Ochola,
Christina Zarowsky, Alexander Dimiti, Peter
Waisswa, Pontius Bayo, Martin Ogwang, Paul
Onek, Donato Greco, Loubna Belaid.
Mid term IMCHA meeting, April 25th 2017

2. IMCHA Project Overview
• Background
Torit, South Sudan: Poor MNCH outcomes, weak health system, external partners supporting the health
system, complex political situation rooted by ethnicity, economic, conflict still occurring (July 2016)
Gulu, North Uganda: post conflict setting, poor MNCH outcomes compared to the national outcomes
• Research questions/objectives
To understand the barriers and facilitators to antenatal care, postnatal care services and facility-based
deliveries
To implement and evaluate the process, dynamics (gender…) outputs and outcomes of participatory action
research (PAR) at community and THE health system levels
To document and analyse the trends in MNCH outcomes and in utilization of MNCH services over time, and
their association with the interventions
• Methods
Mixed Methods (qualitative and quantitative), Quasi experimental study design informed by a baseline
formative research, iterative process, feedback, annual workshops, process and impact evaluation

3. IMCHA Project Implementation
Results to Date/Key Lessons Learned
- Post conflict: food insecurity (Torit), destruction of infrastructure, poverty, high illiteracy,
gender norms (Gulu)
- Barriers to access to healthcare: Torit: Physical and economic accessibility, poor perception
of quality of care, poor infrastructure Gulu: In addition, gender issue (lack of male
involvement)
- Capacity strengthening: Team (research), Health providers (medical training/ refresh courses
on MNCH, leadership/management)
- High ANC (98%) and facility delivery (89%) in Gulu, but poor PNC (58%), 57% abused, esp
physical and emotionally.
Challenges in Implementation and Mitigation Strategies
- Torit, SS: insecurity, weak health system (drugs, supplies, skilled health staff..), incentives for
the communities, HHP ?
- Strategies: strengthen health system before implementing, advocacy to the MOH for the
skilled staff, supplying drugs and supplies
- Gulu, Uganda: working with CHW, incentives

6. IMCHA Project Implementation
Implementation Research Team – Focus on Capacity Strengthening
- Torit, South Sudan: Dr Dimiti and Dr Elijo
- Gulu, Uganda:
Next Steps (Plan for 2017) and Areas for Collaboration
- Plan the intervention, writing protocol of intervention (in progress)
- Implementing intervention at community and health system levels (Summer
2017)
- Collaboration: targeting organisations and key individuals from organizations