Monday, February 14th, 2011
In the morning, I drove up from Kampala again to the Mwera Health Center IV. I met with Honorable Sylvia Ssinabulya (the female Parliamentarian from Mityana and, also, an LfM Board Member). She took time out of her campaign schedule to meet with me and I briefed her on the Life for Mother’s pilot project to reduce maternal/neonatal mortality. I explained its holistic properties and the time frame of the project as well. I also gave her the informational DVD that is currently being televised in the US through February 2011. We scheduled another meeting for February 21st, after the Presidential & Parliamentary elections.
Later the same morning, we held an orientation meeting for the recruited 25 Village Health Teams. Each VHT comprises two Community Health Workers (CHWs) per team. Mr. William Nabangi mobilized these teams over the weekend. He mobilized 44 CHWs, divided into 28 women and 16 men. He was only able to get 44 CHWs due to the short period of time. We told him he needed to recruit an additional 6 men to complete the recruitment of the 50 CHWs. The orientation meeting lasted over 3 hours where I emphasized the importance of the CHWs’ role in making the project succeed. I explained the holistic strategy we were employing as well as the use of mobile health technology. In addition, I made the following points:
- The pilot project would take between 4 and 6 weeks.
- The goal of the project was to register as many households during this 4-to-6 week period as possible, as well as increase the number of antenatal visits and births that take place at the Health Center IV. I made them aware of the fact that 40% of all the deaths of children under the age of 5 take place in the 1st month of life; therefore it was necessary for the VHTs tand HC lV to closely monitor newborns during this critical time period.
- All VHTs will be given comprehensive intervention training in the following areas: family planning, HIV/AIDS, maternal/reproductive health, & child survival.
- Each team will be given, and trained to use, mobile phones to register all households in their respective villages. Initially, after the software applications have been placed on these mobile phones, the VHTs will be subjected to a simulated session where each VHT will act as an interviewer and the other as patient. During this time, the IT director will determine which teams can be trained in the usage of these phones; he will be assisted by a Peace Corps Volunteer who is stationed at the Health Center IV. The teams unable to be trained to use the phones will be replaced with new recruitments. Those teams will go through the same process. Once we are reasonably confident that they can be trained in the usage of the phones, they will receive the educational training previously mentioned.
After returning to Kampala, I met with the Commissioner of Health Services Planning, Dr. Francis Runumi, at the Ministry of Health and gave him the informational DVD. The meeting was extremely positive; I re-introduced him to the pilot project and he recognized the significant impact the project could have on Uganda’s health care system. Earlier at the HC lV, during the Q&A with the VHTs, I was asked what Life for Mothers would do to address the gaps in human resources, drugs, equipments, and supplies that women of reproductive age encounter when they come to the HC IV. I communicated the VHTs’ concerns, and Dr. Runumi asked me to return to Mityana and meet with the District Health Officer, Dr. Francis Kigongo. He told me I should ask Dr. Kigongo to write a special request for additional drugs, supplies, equipment because of the increased demand that would be generated by the implementation of the pilot project study. After receiving this letter, Dr. Runumi would request these additional provisions from the National Medical Stores.
Tuesday, February 15th, 2011
I visited the AIDS Information Centre (AIC) to discuss LfM’s pilot project with Dr. Raymond Byaruhanga. Unfortunately Dr. Raymond Byaruhanga was not available and I met with two of his trainers. Since 1993, the AIC has been providing family planning services in addition to comprehensive AIDS/HIV counseling, testing, and treatment. Regarding Family Planning services, we discussed long-acting and permanent method procedures (LAPM.) These included the following: IUDs, the placement of Norplant, inject-able hormones, tubal ligations, and vasectomies. Dr. Proscovia Namuwenge (one of the trainers) and I agreed that she would be able to train the clinical officers and/or nurses in the placement of Norplant procedures.
After arriving back in Kampala, I met with Dr. Hugh Cameron (PhD), Visiting Professor and Department Head of Innovations of Software Development, Faculty of Computing and Information Technology of Makerere University. I introduced him to Life for Mothers, explained the pilot project, and gave him our informational DVD. We discussed the utilization of mobile phone applications to collect health data and register all households in the field. Dr. Cameron recommended that LfM create a very user-friendly prototype for the initial mobile phone data collection. He further recommended that we work with the VHTs with this prototype to determine their capability to be trained in the usage of this technology. LfM will be working very closely with Dr. Cameron’s team to design questionnaires to be used as the prototype. Once developed, the software would be uploaded onto the phones, and we would meet with the VHTS to go through a trial period to determine who was capable of being trained in this technology.
Wednesday, February 16th, 2011
I drove up to meet with the District Health Officer of Mityana, Dr. Francis Kigongo, and discussed the prior conversations that I’d had with Dr. Runumi the previous day. I also met with Dr. Robert Balikudembe (the Medical Officer assigned to the Health Center IV in Mwera.) We worked on drafting the letter to the Permanent Secretary of the Ministry of Health requesting the additional supplies due to the pilot project study.
After I returned to Kampala, I had another meeting with Dr. Cameron to further discuss the development of the questions to be used on the mobile phones. He introduced me to his team and related to me that they would be working on a daily basis, throughout the Presidential election period.