FOCUS ON MACHS=MATERNAL AND CHILD HEALTH CARE SERVICES
The challenge
Infant and child (under 5) mortality stands at more than 20% annually, in Teso, with the child mortality of 137 out every 1000 new born (Uganda bureau of statistics 2011).
This is coupled by burden of preventive disease! Where malaria alone accounts for more than 44.7 %, of all under five deaths , followed by pneumonia at 16.6 % , while inadequate hygiene and sanitation contributes to 70% disease burden among children especially diarrhea and intestinal worms and skin infection. This occurs especially in Katakwi, Amuria and Bukedea districts that have on average only 31% of latrine coverage (Ministry of Health report 2010).Other diseases affecting children include HIV/AIDS that has affected Malera Sub County in Bukedea district and ranks highest in the whole country. Malnutrition, urinary tract infection, pelvic inflammatory diseases and gastrula disorders, as well as other immunisable diseases, including the recent rise of Hepatitis b are an added disease burden.
The escalation of these diseases is mainly due to lack of knowledge by caretakers and parents. About child care and disease prevention, more than 45% of mothers and guardians are illiterate with very limited elementary education.
A high child mortality and disease burden in Teso sub region is also because of structural challenges! With one health center per parish and in some cases none to serve over 20,000 persons. And five main public hospital , including only one referral hospital which are severely under stocked and understaffed serving the entire Teso population of 2.5 million persons( Uganda Bureau of statistics ) therefore expectant mothers have to move long distances to give birth and or seek medical care for themselves and their children . Also discouraging is the fact that the families have very little resources. There is also a biting poverty problem among the parents and care takers to meet Medicare bills for children, with less focus on family planning with averagely 6.8 children per mother.
CURRENT MADI HEALTH INTERVENTIONS
ACTIVITY 1: CHILD CARE AND DISEASE PREVENTION PROGRAMME (CCDP)
This is undertaken through health awareness creation sessions/ outreaches conducted by MADI staff and volunteers on daily basis (Monday to Thursday), and public mass sensitization on radio. Also through other avenues such as : music , dance and drama by MADI trained groups. MADI is looking forward to establish more community drama groups and strengthen those in existence to compose and present songs that educate the members of the public in this area.
Under awareness emphasis are the following sub topics:
- Care during pregnancy or antenatal
- Care of the mother after child birth / postnatal care
- Care of new born babies.
- Immunization
- Malaria
- HIV
- Nutrition
- Housing and sanitation
- Family planning
- Growth monitoring and promotion and
- Breast feeding.
So far a total of 9000 mothers and care takers have been reached through health education talks at Kumi Heath centre IV where MADI staff is deployed. The program targets 14000 mothers and childcare takers in Kumi district.
Treatment, disease control and care for children and mothers.
MADI utilizes the approach of empowering rural health clinics , hence will direct equipment, volunteers, and medical personnel to the hard to reach places to deliver health services .The goal is to encourage child health checkups and immunizations and to offer treatment to common diseases affecting children , with an efficient referral system in place for serious cases. MADI community Pediatric clinics will be established to offer antenatal and delivery services , child nutritional services , counseling, basic treatment and referrals working in collaboration with local health systems . Malaria control also will be tackled in this same approach by the provision of treated mosquito nets . Working with institutions and medical personnel in the United States, MADI plans to recruit and place volunteer medical professionals and students in these clinics to add value as they seek to make a difference in the lives of the villagers and gain experience as they grow in their medical careers.
MADI will also offer care and support for children living with HIV/AIDS through nutritional supplements and anti retro viral drugs program. Care will also include referral for serious opportunistic infections.
MADI Care Clinic will operate as a subsidize healthcare clinic to low income individuals living in the coverage area. The clinic is mainly focus on issues related to mothers and children. However, due to the high demand for other groups and illness in the community coupled with the lack of access to an alternative clinic, MADICare will accommodate out patient services part time, based on the availability of a medical doctor to diagnosis, prescribe, and make referrals accordingly. Qualified individuals and families will receive subsidizes cost for the services they received while unqualified patients are charge more but below the regional or national average cost of the given service.
A part of our medical outreach is supporting clinics that are lacking extensive amount of medical supplies and equipment. MADI supported clinics receive donations of medical supplies in exchange of providing care to women and children referred by MADI authorized personnel or approved community Health Worker. Qualified clinics are pre-screened to make sure they meet the criteria as stated in the organization’s policy. A referral system has been developed to ensure efficiency and to avoid abuse.
