Celebrate Solutions: Community Health Workers in Uganda

By: Mariko Rasmussen, Program Assistant at Women Deliver

Five days after twin bombings hit the capital city of Uganda in July, the annual African Union Summit converged world leaders to discuss the theme of maternal and infant health, highlighting the issue of political instability and civil unrest in relation to development issues. While Uganda has made progress in improving maternal health, meeting MDG 5 will require a steep decline from 550 maternal deaths per 100,000 live births in 2005, to 131 in 2015. It remains a daunting task, but Uganda has implemented a number of interventions aimed at improving maternal and child health and increased government funding towards such projects.  

One project that has shown success works to combat post-partum haemorrhage (PPH), one of the top five causes of maternal mortality in the developing world. In June 2008, misoprostol tablets were registered for prevention and treatment of PPH in Uganda. The Ministry of Health approved a guide for health care providers, “Prevention and Treatment of Post Partum Haemorrhage Clincical Guidelines for the Use of Misoprostol,” on how to use the tablets to manage this important cause of maternal death and disability in Uganda. Venture Strategies Innovations collaborated with the Ministry of Health to support the introduction of the easy-to-use tablets in health centers, including the training of doctors, nurses and midwives, and distributing the tablets in hospitals and health centers in 11 districts.

However, some families are not being reached by the current safe motherhood initiatives in Uganda due to their rural location. Another maternal health project, launched by BRAC, a development organization dedicated to alleviating poverty, aims to reach these marginalized women through training community health volunteers (CHVs). BRAC is supporting 1,880 CHVs selected from BRAC’s microfinance groups and training them to provide basic health care. The dedicated CHVs bring essential healthcare services to between 150 to 200 households in their communities each month, including basic treatments for illnesses and education about common diseases like malaria and diarrhea. Another focus is to check to see if there are any pregnant women in the house and to raise awareness on pregnancy care and ante-natal danger signs. CHVs mobilize pregnant women for tetanus toxoid vaccination and immunization for their children. As an incentive for CHVs, they earn a small income from selling health care products such as contraception, sanitary pads, soap, and insecticide-treated nets. To support and supervise CHVs in their work, Health Project Assistants (PAs) make ante-natal care visits, checking blood pressure to determine if a woman is likely to have a high risk pregnancy and referring them to a nearby health facility for medical treatment. They also calculate the expected delivery date, and educate pregnant women on nutrition, hygiene, safe delivery, care, and immunization.

As of August, the BRAC health programme in Uganda, working through 97 Project Assistants covering 94 branches in 42 districts in the country, reached a cumulative total of 13,589 mothers for ante-natal care and 1,052 women for pre-natal care. This means 14,144 pregnant mothers were referfered for tetanus toxoid vaccines. 46,114 children were mobilized for immunization and 5,023 condoms were distributed. In general, in August 2010 a total of 97,059 patients were referred by BRAC CHVs to health centres and 41,851 community health meetings were conducted.

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