Sports among Sabiny may end Female Genital Mutilation

“Kapchorwa” for many Ugandans is synonymous with Olympics or running, simply because it is home to some of the greatest runners that Uganda has ever produced to compete internationally. Yet the same Kapchorwa is associated with Female Genital mutilation (FGM) since it’s home to the Sabiny. Almost every girl in Sabiny land has been subjected to Female Genital Mutilation (FGM) as a teenager, and those growing-up will have to face the blade as they approach their puberty if the practice is not completely out-lawed. Read more

Uganda short of 3000 midwives

“I was inspired into midwifery when my cousin sister lost her first child during child delivery, she labored for so long and no one was there to help her. When she got pregnant again, I helped her deliver but got stranded when I had to get rid of the placenta. I had never delivered a mother before, but I was determined to save my cousin’s baby. These were the words of Joyce, a young Karamojong woman now training in Mid-wifery.

My inspiration came from a personal bad experience with a mid-wife, when I gave birth and out of carelessness, my baby dropped down and died. The mid-wife had been extremely rude to me. said Apio another young trainee.

Read more

Solar Suitcases bring joy to mothers and relief to health workers in Karamoja

Last week while on a UN Women funded trip to Karamoja to follow –up the progress on powering health facilities, I met a nursing officer Achech Rebecca at Rupa health Centre III and in the course of a brief conversation with her, I asked how many babies she had delivered. Read more

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Cut demand and you will stop Female Genital Mutilation in Uganda

It was the very first of its kind, a half-marathon that attempted to engage, involve and educate the masses in Sabiny land about the dangers of Female Genital Mutilation (FGM) and by extension end the practice.  It took place on 19th September 2015 in Kapchorwa.

Read more

Life is Sexually Transmitted

 

“We
are all products of sex and we should not feel ashamed talking or reporting
about it”. These were the opening words of Lisa (Not real Name). She was
speaking to Journalists and Communication officers at a training on reporting
health at Voice of America (VOA) offices during the AIDS2012 conference in
Washington DC, which I was privileged to attend. Lisa was HIV positive and she
said that she was not happy about the little attention that’s given to
reproductive health issues by mainstream media. Her argument was that; many
people are not comfortable talking about SEX.
Asked why, she said that’s her mission now, to find out the big
“WHY”.

Read more

Barriers to mHealth adoption in Sub-Saharan Africa

In Uganda, and Africa at large, the
populace face many challenges with regard to health including but not limited
to; poor facilities, poor social infrastructure, energy shortage especially
electricity and limited access to education. Despite Government’s effort to improve
on the health system, very few individuals, companies and organizations are
tapping into the potential of mobile Technologies for health, even when the
benefits are obvious to populations whose most accessible tool for communication
is a phone. Below are some of the reasons that I personally think contribute to
the little uptake of mhealth.
 
Photo Credit: Edward Echwalu
1.     
Content
The absence of
readily available mobile health related content on specific thematic areas is a
big barrier. Most organizations that implement mhealth projects have to develop
their own content based on the area of focus. eg HIV, Malaria, maternal health
etc. There is also no central database where this content is put for future
reference or to avoid duplication of already implemented mhealth issues. This
leaves room for data redundancy and duplication to target groups.
 
2.     Skills
Because of the
tremendous growth in phone penetration especially in sub-Saharan Africa, there
is a great demand for training in mhealth education. One cannot simply rely on
the assumption that because every at least many people own phones, they can
ably use them for mhealth campaigns. They need to be trained on how to operate
the phones, say for health related surveys or how to respond to health quizzes.
This is still lacking. Unless the mhealth campaigns are inform of interactive
Voice Responses (IVRs), the adoption will still remain slow with the use of
interactive SMS messages especially among the elderly populations.

3.     Gender
Although this
is an issue that is often under looked, it plays a key role in either the
success or failure of mhelath project. It’s obvious that the biggest percentage of those who bear
the burden caused by conflict ,disaster are women and children and they are the
key stakeholders in promoting good health and building stable, self-reliant
communities. Also most mhealth related campaigns target mainly women on issues
like maternal health, child mortality, HIV/AIDs, abortions etc. but ownership
of phones is predominantly male who control what kind of information comes
through the phone, whose mobility is not restricted and who are better economically
empowered to afford maintaining the phones especially in rural areas. Therefore,
Making these projects gender sensitive and involving men right from the onset
of the projects will reduce the barriers.
 
4.     Access/Affordability
This could be viewed in terms of
access to the actual handset especially for the rural folks in rural Africa and
affordability in terms of maintenance such as paying to have the phone charged.
Many people cannot afford a 30USD handset yet most mhealth implementing organizations/companies
only want to work with folks that already own phones. It’s a barrier because
you reach fewer people.

5.     Infrastructure
A lot of mhelath projects in Africa
depend so much on Telecom companies which are responsible for the general
telephony infrastructure eg masts for access to network, distribution of short codes
for those that intend to use SMS etc. In the event that an area does not have
access to a mast, then it is obvious that even if there is a genuine health
need to be addressed through the use of mobile phones, it does not get
attention simply because there are issues of network connectivity. This is one
of the biggest barriers for rural Africa. Also the issuing of short codes by
the Telecoms through communications regulators is bureaucratic.

6.     Attitude
Traditionally
especially in Africa, mobile phones are known for verbal communication. But
with mhealth projects comes a new paradigm shift to the use and application of
phones for accessing health information through SMS. Accepting this change and
adjusting accordingly can be a barrier to SMS based mhealth project. IVR
related mhealth campaigns could be more successful than SMS because voice
messages cut across literacy levels.

7.      Language
This is a barrier because of the fact that the commonly used
language for SMS is English yet sub-Saharan Africa is so diverse. However, this
barrier can be solved through voice messages and using community radios along side the mobile phones.

8.     Political
Will
The success of any project depends on the
positive political will and government support. Often times, mhealth initiatives
by NGOs are meant to compliment already existing government health services and
therefore they must work closely with Government. However, many initiatives
have been destroyed because the Government has not played its role. A case in
point is the moratorium that was issued in Uganda from the Ministry of Health
halting the implementation of all electronic and Mobile Health projects that
were not approved by the Director General. While this was a great initiative to
reduce on duplication of projects and to encourage wider coverage and eliminate
unnecessary pilots, the Ministry did not make the vetting process smooth. It
would take months to have the technical working group at the ministry meet and
approve the projects. This is a source of frustration for projects that have
defined timelines.

Samsung solar powered Mobile Health Centre(s) in Africa

2013 theme: “Journey of Wonders”

I was privileged to attend the 4th
Samsung Africa Forum that took place in Cape Town from 12th -17th
March 2013. It was indeed a “journey of Wonders” that truly reflected this
year’s theme.  A few years ago, not so
much was known about Samsung products, but today, they have become a household
name as seen from many of their products like the Galaxy phones, Televisions,
Fridges, cameras and washing machines among others. With a total of over 200
Journalists and bloggers from all over the African continent in attendance, the
forum recognized the role played by media in reaching out to their clientele
and informing the public about their products and services.  According to Mr. KK Park the CEO of Samsung
Electronics Africa, “Samsung’s Key
concern has been, and will continue to be, how to develop the technology to
resolve all the difficulties that African People can face”
He adds that
Samsung’s presence in Africa is about bringing Samsung’s Smart world to the
continent, creating a smarter eco-system for Africa with a purpose to
contribute to the society because business exists to make a contribution to
human society and if the contribution is recognized, the business grows and so
do the profits, revenue and brand reputation.
Changing
the Face of Africa’s remote Areas with Mobile Health Centres
The Mobile Health Centre Truck
When someone reads “Mobile Health”, the first
thought is a mobile phone being used to share information about health in
Africa like it has always been the norm. Samsung has a different approach to
Mobile health. It has set itself a goal to reach one million people by 2015 through
a solar powered mobile health Centre on the back of a track fitted with medical
supplies and qualified medical staff.
As part of its broader cooperate social
responsibility goal, it aims at positively impacting the lives of five million
people in Africa by 2015.  According to the World Bank , more than 60% of people in sub- saharan Africa live in rural
areas,
and people often lack time and resources to reach clinics, particularly if they
are sick.
The centre, essentially a solar powered shipping
container, contains equipment that allows for a range of medical services to be
performed and these include dental services, screening, radiology and ophthalmology.
 Some of the medical partners in this
project include World Vision, Doctors without boarders ,South African
Department of health and Aspen Phamaceuticals.  
Innovative
Technology can transform Lives in Africa
It is evident that across Africa, the populace faces
many challenges such as poor health facilities, poor social infrastructure,
energy shortage especially electricity and limited access to education
facilities yet Africa has been blessed with plenty of natural resources such as
sunshine.  Samsung’s innovation of the solar
powered mobile health centre is of great relevance to a continent where
millions of people are not yet online and the investment in such innovative
technology from such business companies needs to be embraced and replicated
allover the continent. Because of the many challenges in  Africa, it seems to be a fantacy rather than
a reality  to promote a larger use
of  mobile health centres like these, but
Samsung is definitely changing this. For so long, Africa has lacked the
imagination to learn the many ways technology can transform lives and not just
transform bank balances of the few companies that control the Technology.  Samsung Africa is determined to transform the
lives of many as a way of giving back to the community that supports them.

Note: These mobile Health Centres are in South Africa

Follow @SamsungSA
#AfricaForum #samsung on Twitter for more details!

Too Young to be a mother: End Child Marriages

On
19th Sept 2012, one of the local Televisions in Uganda (NTV) broadcast
a story of a 12 year child mother who gave birth in Gweri sub-county Soroti  a district Eastern Uganda.  The young girl whose names have been withheld was
quoted to have said “I didn’t expect to get pregnant but I love my baby”.  This case is one of the few of hundreds cases
of defilement which take place in Uganda. Circumstances surrounding her pregnancy
are still unclear but Police officer Florence Adong who is responsible for
Children and Family protections said she was going to move like a lunatic in
Soroti to make sure Justice Previals. On 11th Oct 2012, the world
will focus on the International day of the GirlChild whose theme is “Too Young to wed: End Child Marriages and
Teenage pregnancies”

 
According to the UDHS 2006, one of every four
pregnancies occurs in a teenager. By 15 years of age, 24% of girls and 10% of
boys are sexually active (debut 16.6 for girls and 18.1 for boys). Yet only 11%
of sexually active young people are using contraception. Uganda also continues
to have one of the highest birth rates in Africa and one of the fastest growing
populations in the world.  This no doubt poses new challenges – more so in
areas such as education and health care delivery given the youthful population
of  – 70% under the age of 24, 56% under 15 years. The  2011 Uganda Demographic Health survey report
also states that 1.6% of girls have given birth with
a first Child by the age 15 while 24% of the girls aged between 15 and 19 are
already mothers or pregnant with the first child. And the
Ugandan Annual Crime and Road Safety report 2011 assets that a total of 7,690
cases of defilement were reported in 2011. Of the 7,690 caese reported to
police, only 3836 suspects were arrested and taken to court. This implies that over
45% of defilement cases are dropped and do not make it to court.

In Uganda 6,000 women die every year from
pregnancy related complications. Many more women suffer long-lasting illnesses
or disabilities caused by complications during pregnancy or childbirth, such as
obstetric fistula, infertility and depression. 
Reviews of the progress on the Millennium Development Goals (MDGs)
indicate that the development goal lagging the most behind is the one on
maternal health – MDG 5. This is the goal that aims to reduce maternal deaths
and ensure universal access to reproductive health by 2015.
The
leading causes of death of maternal deaths are over-bleeding while giving
childbirth, infections, high blood pressure, and prolonged labour. Some women
die because of unsafe abortions while they are trying to get rid of unwanted
pregnancies. 

Photo by Echwalu Edward
While
attending the first ever African Youth Forum that took place from 17th
to 19th July 2010 in Uganda ahead of African Union summit whose
focus was on reducing maternal, infant and Child deaths, the youth called for
action on a number of issues one of which was child marriages.  Some of the qustions asked were; 

·        
Why
are young girls getting pregnant?
·        
Why
do young Mothers die more than old mothers?
·          Why are the young boys/men getting them
pregnant and not taking responsibility?
·        
Why
do so many lose their lives when pregnant or giving birth?
·        
Why
is the issue a young person’s issue?
·        
 Why do/don’t young girls abort?
·        
Why
don’t teachers teach about maternal health but continue to harass them?
·        
Why
does the community make them vulnerable?
       If you cannot
understand WHY, you cannot take the right decision
.
      We all have a
role to play in Ending Child Marriages
      Now is the time
to act. With the current heated discussion on allocating more funds to the
health sectore we hope for  increase in
political will, financial commitment and action from everyone, the number of younf
girls getting pregnant will drastically reduce. UNFPA Uganda believes that, no
woman should risk her life while giving birth as as part of this year’s
international day of the Girlchild, UNFPA is organizing a couple of events to
create awareness about ending child marriages and giving each and every girl an
opportunity to take charge of their reproductive health because everyone
counts. UNFPA believes in delivering a
world where every pregnancy is wanted, every child birth is safe and every
young person’s potential is fulfilled.
Each one of us has a big role to play
in ending child marriages within our families and communities. 
   
   Read Similar stories about Child marriages in Uganda 
  1.  EchwaluPhotography: Child Marriages through the lense

Mobile phones for Family Planning in Uganda

As health practitioners, politicians and entrepreneurs from all walks of life gathered in London for the Family Planning Health Summit, the rest of the world commemorated World Population Day
on July 11th 2012 with this year’s global theme being “Universal Access
to Reproductive Health Services”. The focus of the family planning
summit was to invest in family planning in order to reduce maternal
deaths and improve womens and girls’ health. I hope that the conference
created momentum and was able to highlight this need to invest in family
planning which will in turn make it a lot easier to achieve Millennium
Development Goals (MDG’s) 4 and 5. Target 5b of the MDG’s is to “Achieve
Universal Access to Reproductive Health by 2015″.

Status
of Family Planning in Uganda
In Uganda more than 4
out of every 10 women wish to access modern contraception to plan their family
but cannot. They have an unmet need for Family Planning. Family Planning alone
would reduce the country’s maternal mortality ratio by 33%. Uganda also has one
of the highest teenage pregnancies in Africa. According to the UDHS 2006, one
of every four pregnancies occurs in a teenager. By 15 years of age, 24% of
girls and 10% of boys are sexually active (debut 16.6 for girls and 18.1 for
boys). Yet only 11% of sexually active young people are using contraception.
Uganda also continues to have one of the highest birth rates in Africa and one
of the fastest growing populations in the world.  This no doubt poses new challenges – more so
in areas such as education and health care delivery given the youthful
population of  – 70% under the age of 24,
56% under 15 years.
How
Mobile Phones facilitate Access to Family Planning Services
In partnership with Program
for Accessible health Communications and Education (PACE) , Text to Change is
using SMS and Interactive Voice Responses(IVR) to reach out to women as well as
check with service providers to find out which women are using family planning.
The project is being carried out in central, western and Northern parts of
Uganda. The IVR are pre-recorded in four languages, three of which are local
(Luo. Runyankole and Luganda) to cater for a bigger majority of the women who
are unable to read or write but who can easily follow the prompts on a phone and
listen to instructions on how to access family planning services in a language
that they are comfortable with within their community. SMS is usually used to
back up the voice and it interactive, informative and incentive based to
encourage more people to use their phones to access these services. According
to the project beneficiaries, this has been a service that has not only added
value to their lives but has also empowered them.
In 2011, PACE’s ProFarm
franchise enambled more than thirty thousand women to receive long term family
planning method (Inter Uterine devices and implants). A total of approximately
1488 have been reached by mobile phone through voice and SMS.
Sources:
1.      PACE
Annual Report 2011
4.      http//www.pace.org.ug

IF WE DO NOT SAVE MOTHERS AND CHILDREN, WE ARE PUTTING THE FUTURE GENERATION AT STAKE.

On 5th
March 2012, I joined a team of medical doctors and environmental specialists
from UNICEF Kampala for a trip to western Uganda. This was a mid-term review on
the progress made in health services provided for a two year project in the
areas of Prevention of mother-to-child transmission (PMTCT), HIV/AIDS and
Malaria. We visited three districts of Bundibugyo, Kabarole and Kyegeggwa. UNICEF-Kampala
in partnership with Ministry of health and other partners like Text to Change
and Catholic Relief Services (CRS), is working tirelessly to achieve the 4th,
5thand 6th millennium development goals (MDGs) of:
Goal 4:
Reduce Child Mortality,
Goal 5:
Improve Maternal Health
Goal 6:
Combating HIV/AIDS, malaria and other
diseases”
The
major objective of this initiative is to increase public demand for Antenatal
care (ANC) and Post Natal care (PNC) services at health facilities among
mothers in rural Uganda.
It is
evident that in emergency, the biggest percentage of those who bear the burden
caused by war, conflict and disaster are women and children, yet they are the
key stakeholders in promoting good health and building stable and self-reliant
communities.  With only 2 years left to
2015, a year set by United Nations to achieve all the 8 MDGs, many organizations
are working tirelessly to meet this deadline. During our 3 day visits, we went
to a number of health centres which included; Burondo HCII, Ntandi HCII both in
Bundibugyo as well as Kigambo HCII in Kyegegwa.
Why Maternal health in Uganda?
According
to the 2010 Millennium Development Goals progress report for Uganda, maternal
health indicators for Uganda have generally remained poor in the last two
decades. Over the period of 1995-2000 maternal mortality stagnated about 505
deaths per 100,000 live births. The Uganda demographic and health survey of
2006 estimated Maternal Mortality Ratio (MMR) at 435 deaths per 100,000 live
births, making a total reduction of only 70 deaths per 100,000 live births in
half a decade. The 2007 ministry of health expenditure survey in Uganda clearly
indicates that the main causes of maternal morbidity and mortality in Uganda
have overtime been considered preventable and or treatable. These common causes
include but are not limited to abortion, haemorrhage, sepsis and obstructed
labour. When we visited Ntandi Health Centre III in Bundibugyo, we were
welcomed by this message;
BUNDIBUGYO
Needs more health centres; Bundibugugyo needs more well quipped maternity
wards”
A banner hanging at Ntandi Health Centre III in Bundibugyo

A
statement that was confirmed by the Chief Administrative Officer Mr. Okuraja David of
Bundibugyo when we later on visited and talked to the district leaders.

At
Ntandi, We met the only enrolled mid-wife Ms. Grace Agaba who was busy helping
carry out in an immunization exercise. When we spoke to her, the visibly tired
Grace emphasized the problem of the health centre being under staffed and sometimes
having drug stock outs. She also complained about the absence of
light/electricity at the centre that makes it complicated to help mothers who
deliver in the wee hours.

“This morning at about 5:00 am, I carried
out a natural delivery using the torch light of my mobile phone
said Grace
Grace
also cited the absence of registers for patient details at the centre, she said
that because of this, mothers are requested to carry exercise books to have
their details written, which she says is not a good option as many loose these
books hence making it difficult to track their health history. When asked by
Dr. Richard Oketch (HIV/AIDS specialist Treatment at UNICEF) about HIV Positive
mothers, Grace said that they test all mothers for HIV/AIDS during their first
visit to the centre and if found positive, they start administering the Antiretroviral
drugs (ARVs) 14 weeks during the Gestation period. They give them zidovudine (AZT) drug used to delay development of AIDS (acquired
immunodeficiency syndrome) in patients infected with HIV until
delivery and then Combivir which is used to treat HIV. For the new born babies
Niverapine syrup is administered within 72 hours of birth, she said.

Grace
expressed a lot of concern for the pigmy community made up of the Bawta in bundibugyo
district. She said that the biggest dilemma is that approximately 60-65% of the
Batwa are HIV positive yet they are very aggressive and difficult to reach out
to with better health services that prevent transmission. She was hopeful that
if they are mobilized through their King, the process will be easy. UNICEF
recommended specific outreach to this group of people through Village Health
Teams (VHTs) from their community.

Hope in Technology through Text to Change.
Will it help?

To realise the indicator of having mothers
come for all the 4 ANC visits, we need to have something that reminds these
mothers
”-Sr. Nyinakamunya Generose

With
such a statement, it is evident that although the mothers go to the Health
centre for Antenatal (ANC) and postnatal (PNC) services, they need to often be
reminded if they are to go for at least the required four visits during pregnancy.
It’s for this very reason that Netherlands National Committee for UNICEF in
partnership with UNICEF-Kampala and the Ministry of Health sought for a partnership
with Text to Change a mobile4dev organisation that improves access to
information in a cost effective way to reach out to several of these mothers through
the Simple Message Service (SMS). For my part, I was tasked with testing the
language and comprehension of some of the messages that have been develop and
this was for one reason; to make sure that they in the simplest language that
can be understood by an ordinary mother but still remain medically correct. I
had to test for the clear understanding and seek alternative options for
medical terms like Convulsion, postnatal, Transmission, premature, ITN voucher,
caesarean section etc.

Maureen Agena texting the language and Comprehension of the SMS messages at Ntandi HC III
Through
short messages, Text to Change intends to reach out to hundreds of mothers by
sending out two 2 to 3 messages weekly on topical issues like malaria,
Nutrition, HIV/AIDS, ANC and Postnatal. It will be backed up with radio programs for a bigger
outreach and greater impact to the communities.
Similar blog of maternal health
by Uganda Journalist Rosebell Kagumiire: