Identify pregnant women in Masaka, Uganda. Train the women in concrete steps they can take to improve the health of their pregnancy, such as eating leafy greens to boost folic acid intake which reduces the risk of hydrocephaly in in-utero infants. Train the women in having a birth plan, including a plan to get transportation to the hospital in time to deliver.
Train the midwives, clinic employees, and hospital technicians in the use and analysis of portable ultrasound machines. Use ultrasounds to identify as early as possible those women who are at high risk of a crisis during labor (babies in breach position, babies with unusually large heads, for example).
Make the transportation plan less of an obstacle by installing a motorcycle ambulance on call for the women.
Gather impact data, refine the program, and expand to a larger geographic area.
Uganda sees 204 lifetime maternal deaths per 10,000 women (compared to 4/10,000 in the US).
Uganda sees 592 infant deaths per 10,000 births (compared to 59/10,000 in the US). (*Based on statistics from UNICEF and the CIA World Fact Book.)
All of the women surveyed who had lost their baby in childbirth and suffered an obstetric fistula live in extreme poverty.
None of the women surveyed who had lost their baby in childbirth and suffered an obstetric fistula had received prenatal care or had gone to the hospital for delivery.
MPA is now offering its newest economic capacity building project in Africa, The Joy of a Healthy Pregnancy and Safe Birth. This project will empower circles of village women to support each other throughout pregnancy, understand the warning signs of a difficult labor, and have a plan in place for transportation to the hospital for emergency delivery. We will enlist the help of area clinics and provide technical training to caregivers to enhance their ability to identify risks. If women can increase their chances of having a healthy pregnancy and safe birth, they can continue to be integral members of their families and village communities, and the babies who are safely delivered into the world can grow and thrive.
At age 20, Menjeri lost her second child in a prolonged and agonizing labor. This labor resulted in an obstetric fistula injury, leaving her weak and incontinent. Her husband banished Menjeri and married a new wife, relegating Menjeri to live in a small shed on their farm. Menjeri has had the repair surgery at Kitovu Hospital, but her situation was still precarious. After she joined the piglet microfinancing project, Menjeri’s husband threw her out. She fled with her son and the piglet to start over on borrowed land. Menjeri’s mother, herself a refugee from Rwanda, has helped her to find new friends who can help her build a new shed for her pig. Menjeri had not received any prenatal care during either of her pregnancies. During the labor of her second child, Menjeri did not know until it was too late that she was in crisis. Like 100% of the post-fistula women surveyed by MPA to date, Menjeri did not have a plan to go to the hospital for her delivery, and she did not go to the hospital. Also in common with other post-fistula women, Menjeri lives in a rural area of Masaka, Uganda, and subsists in extreme poverty.