The Uganda program continues to grow and learn. Berkeley graduate students Melissa Ho and Matthew Hamilton presented at the recent annual meeting of the American Public Health Association (APHA) in San Diego. Melissa is developing an early version of a mobile medical claims management system for the Uganda OBA program. Information management is critical for proper patient treatment and valid reimbursement and her system is a big step in the right direction. Her APHA slides are available here. Matt presented on preliminary findings from the “before-after” population evaluation (hamilton-apha-slides). We looked at two specific outcomes: knowledge of STI symptoms and syphilis prevalence. The analysis is crude (my insistence on sharing what we know now) and further work is underway to make the comparison truly comparable between baseline and follow-up surveys. Knowledge of 7 of 9 STI symptoms appeared to improve between baseline and follow-up. More promising, syphilis prevalence (TPHA and VDRL results) showed a decline between 2006 and 2007. A mile-high caveat on these findings - we have yet to control for secular trends and compositional effects in these data. More coming soon …
Recent presentations at APHA conference
November 6th, 2008 · No Comments
→ No CommentsTags: Conferences · Evaluation · Presentations
“HealthyBaby” delivery voucher launch
October 10th, 2008 · No Comments
The next phase of output-based aid in Uganda has begun to provide subsidized delivery care for 90,000 poor women in the west of the country. On behalf of the Ministry of Health, Marie Stopes has contracted thirteen facilities with another 70 potential facilities to join in the next nine months. The voucher is sold by community-based distributors trained to screen potential patients using a MSI-developed participatory poverty grading tool. Women who qualify pay 3000 Uganda shillings (roughly US$1.40) for a voucher that entitles them to four antenatal clinic visits, delivery care at contracted facilities, and post-delivery care at their choice of facility.
The program was launched September 18th in Mbarara. Photos linked here. The Honorable Richard Nduhuura gave the keynote address, copied below.
KEYNOTE SPEECH BY HON. RICHARD NDUHUURA
Honourable members of parliament
The Development partners
The District Chairman
District council members,
The district health teams
Distinguished delegates
Ladies and gentlemen.
I feel greatly honoured to have been invited to the launch of this project. In a special way, I wish to thank all of you who have made it to this occasion. I also warmly welcome the development partners and the district teams who have travelled all the way to Mbarara. I thank you for your commitment.
Uganda has registered improvements in the reproductive health indicators over the last 5 years. For example the number of women delivering under skilled attendance has increased from 37% to 42%, while antenatal care (4 visits) increased from 42% to 47%. Adolescent pregnancy decreased from 32% to 25%. Similarly infant mortality rate declined from 88 to 76/1000 live births. However maternal mortality is still high and decreased from 505 to 435/100,000 live births; while total fertility is 6.7 and has not declined much.
Ladies and gentlemen, we are all aware that childbirth should be an event for celebration and merry making. But many times in Uganda it becomes tragic when the life of a mother is lost as she tries to bring another life to this world. Globally, 500,000 women die from complications of pregnancy and childbirth every year. 99% of these deaths occur in the developing countries including Uganda.
In Uganda, we have a Health Sector Strategic Plan which identifies family planning, emergency obstetric care and skilled attendance at delivery as key component of a reproductive health package to address maternal mortality. We have completed a Road Map to the reduction of maternal and neonatal mortality which aims to address health system issues. Uganda is currently addressing some of the health system issues like improved staffing, construction and expansion of health units to offer emergency caesarean section, availing blood transfusion services and ensuring adequate supplies and drugs are available.
The project we are launching today aims at reducing the number of mothers and children dying or being disabled due to absence or under-utilization of skilled medical attendance during pregnancy and child delivery. It also aims at reducing the burden of sexually transmitted diseases through the introduction of a voucher system.
The safe delivery vouchers will substantially contribute to reducing maternal and infant mortality in this region. This will also increase the overall health of newborns, children and their mothers. Regular antenatal care that allows screening of the target population for risk factors during pregnancy and delivery has proved to have a huge impact on mothers and children’s wellbeing.
The STD voucher is designed to decrease the burden of STDs in Western Uganda. The treatment of high risk groups not only helps to ease the burden of those infected but also allows prevention of HIV transmission. The project will have a positive impact on the Ugandan health system. It is anticipated that in the three year period, the project’s output will be 110,000 safe deliveries and 35,000 cases of STDs treated. This project is implemented through a public-paternership strategy and we hope the experience learnt will help to improve the health system in this region.
Let me now call upon district leaders, the members of parliament, the district health teams to work closely with this project to achieve the successes required.
On behalf of the Ministry of Health, let me take this opportunity to pledge support to this project and the districts in order to improve the health status in this region.
I wish to thank the Government of the Federal Republic of Germany through the KfW group, the Global partnership on Output Based Aid and the World Bank for funding this project.
It is now my pleasure and honour to officially launch this project and I wish you all the success.
For God and my Country