Rapid scale-up and deployment of a district-wide emergency maternal-child referral network during a national medical strike
Mukalu, Mohamed Makuuza
Omulangira, Mali Ronald
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Background: In November 2017, a nationwide strike of healthcare workers commenced to protest unfavourable working conditions in Uganda’s public healthcare system. The strike left many hospitals abandoned and life-saving surgical care unavailable. As leaders of a community-based organization, Safe Mothers, Safe Babies (SAFE), focused on improving maternal and perinatal survival, we shared the valid concerns of health workers but also cared about the mothers and newborns that would die from treatable complications during the strike. Objective: To mitigate anticipated mortality, we sought to expand our existing maternal and child emergency referral network to serve the entire Iganga district. Methods: SAFE convened the “Humanitarian Emergency Response [HER] Network” to facilitate partnership and response with other organizations. Two of the partners were private healthcare facilities with surgical capabilities. Marie Stopes furnished vouchers to reduce delivery costs in private facilities whereas volunteers the +256 Youth Platform managed referrals. We distributed our central dispatch number to all health facilities, made radio announcements, prepared motorcycle ambulances, a car ambulance and prepared our own existing health facility to handle increasing patients. Results: Within three weeks, we responded to 15 maternal emergency calls, performed over 17 deliveries in our own facility. Since the end of the strike, the network has rescued an additional six mothers and five babies through emergency caesarean sections. Conclusion: Collaboration between district leadership and organizations to create contingency plans for obstetric care during humanitarian crises is essential and can be effective at reducing maternal mortality. The elements of the HER Network included: distribution of our central dispatch number to all health facilities, posting it outside the hospital, and making radio announcements so the public knew about the strike and how to reach the ambulance service for maternal and perinatal emergencies. (2) Preparing our three motorcycle ambulances and obtaining a car ambulance from a local politician. And (3) Preparing our own existing health facility to handle an increasing patient load. Safe Mothers, Safe Babies is a non-governmental organization that works in East-Central Uganda. SAFE works in five districts with the bulk of their work in Iganga District and directly serves around 160,000 people. Their work focuses on improving maternal and child health by focusing on the Three Delays through a community-based participatory approach.
- Save The Mothers