Improving Maternal and Newborn Care in Northern Uganda Change Package
A synthesis of the most robust, high-impact and evidence-based changes that resulted in facility and community-level improvements in the processes and systems of providing maternal and newborn care services
Uganda’s maternal and newborn mortality remains unacceptably high (438 maternal deaths per 100,000 live births and 27 per 1,000 live births respectively). Most of these deaths occur around the time of labour, delivery and immediate postpartum. The Saving Mothers, Giving Life (SMGL) initiative launched in 2012 focused on implementing existing high impact and evidence-based interventions to accelerate the reduction of maternal and newborn deaths in sub-Saharan African countries, starting with Uganda and Zambia (Phase I). It was designed to address the three major delays in health service delivery that are often associated with maternal and newborn deaths: a) delays in seeking appropriate care, b) inability to access the most appropriate care in a timely manner, and c) inconsistencies in the quality of care provided at health facilities.
Phase II of the initiative was scaling up to six districts of northern Uganda. This was supported by USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project through funding from USAID. Part of this phase was the community component which addressed the factors affecting pregnant women and their facilities to make decisions and reach facilities in a timely manner. The interventions to prevent and address gaps became the focus of USAID ASSIST’s quality improvement efforts.
This change package presents a synthesis of the most robust and effective changes in improving maternal and newborn care at health facilities and communities in 6 districts of northern Uganda. This package has two sections. Section I presents the community and Section II the facility level aims, indicators, results and key change ideas. Each result area describes a key change idea and detailed description of how the change was implemented and the result. The ideas are focused around the improvement objectives and results achieved.
Facilities and communities are to use these change ideas which they believe may work in their context. As they adopt these ideas they are to monitor performance using data to see whether it works in their setting or modify the ideas. Teams can use the change concepts to generate other change ideas.