Location: Karamoja, northern Uganda
The Karamoja Integrated Maternal Child Health project was successfully completed in March 2015.
Since 2006, Samaritan’s Purse UK (SPUK) and Samaritan’s Purse Uganda (SPU) have worked with vulnerable populations in Northern Uganda to address health needs. From this work and from a review of the progress towards achieving the Millennium Development Goals in Uganda, SPUK and SPU became aware that the Karamoja sub-region was grossly under-served for maternal child health.
SPU consulted beneficiaries, including community women’s groups, in Napak district participating in other SPU-led projects in the region. These consultations identified the need for nutrition, public health education and access to health services as priorities.
The Karamoja Integrated Maternal Child Health (KMCH) was a three year project implemented in the impoverished Napak district of Karamoja, a sub-region of Uganda, which sought to improve the health of women and children.
The goal of the project was to reduce maternal and child mortality. This was to be achieved by
- Establishing Care Groups and building their capacity to promote MCH in their communities;
- Pregnant women and caregivers of children <5 years with increased knowledge and capacity to exhibit healthy MCH behaviours;
- Community members aware of MCH issues and provide enabling environments for their households to adopt positive behaviours and access services;
- Improved continuum of care available for MCH services.
The project took on a three-pronged approach:
- Empowered women with the knowledge; skills and attitudes they needed to improve MCH and access locally-available services.
- Addressed cultural barriers and engaged the wider community to ensure a supportive environment in which women were able to take charge of their health and the health of their family.
- Supported health personnel to practice Integrated Management of new-born and childhood illnesses (IMCNI) and lobbies Ministry of Health for improved service provision where it is lacking.
To achieve this, the project adopted the Care Group (CG) methodology to ensure that accurate information about MCH was disseminated at grassroots level throughout the target population.
The project achieved strong improvements in the areas of infant nutrition, MCH service utilization and MCH capacity building. A total of 37,727 women of reproductive age were educated and learned to see themselves as powerful agents of change in order to impact the health of their families and communities. The project created a community-based health promotion system that engaged an extensive network of volunteer women. This network has supported effective teaching on MCH topics and has made steps in strengthening the link between communities and the health system. The project also created a strong environment for healthy maternal and child health behaviours at the household level which was a key strategy for reducing maternal and child morbidity and mortality.
- Improved health seeking attitudes among women of reproductive age: Women in Napak have significantly changed the way they view health care services and how often they access these services.
- Improved care of young children in Napak: Mothers stated that they now know what they should be feeding their children and take extra measures to ensure their children eat well. Women also stated an increase in hygiene habits which reduces the likelihood of diarrhoea. Mothers were also seeking care from Village Health Teams and the health centre staff than they did in the past.
- Increased empowerment of women: Women in Napak are now seen as effective agents of change compared to three years ago before the KMCH project began.
Thoughts from some of the beneficiaries of the impact of the project:
“We must be an example and a role model so that the neighbours will learn that what I am saying is true. We shouldn’t just talk to the mothers about having a latrine if we don’t first make one in our home. We must be an example.” Leader Mother, Ngoleriet Sub County, 28/01/2015.
“My children used to be very dirty, and in the morning I would fetch firewood straight away before cleaning the children and burying the faeces. Now the first thing I do is cleaning the household.” Neighbour Woman, Lotome Sub County, 30/01/2015.
“We cannot reach the communities, so the leader mothers play an important role in reaching out to the community with these messages.” Midwife, Lotome Health Centre, 30/01/2015.
With the completion of the project, an independent evaluation was undertaken by Jigsaw Consult. The project created a community-based health promotion system that engages an extensive network of volunteer Leader Mothers and Leader grandmothers. This network has supported effective teaching on Integrated Management of Neonatal and Childhood Illnesses (IMNCI) and has made steps in strengthening the link between communities and the health system. The project has delivered its four outputs and there is evidence of knowledge transfer and behaviour change, particularly among Leader Mothers and in the area of hygiene and sanitation.