A sector‐wide approach to emergency obstetric care in Uganda

Orinda, V.; Kakande, H.; Kabarangira, J.; Nanda, Geeta; Mbonye, Anthony K.

doi:10.1016/j.ijgo.2005.07.023

Cited by 33 publications

(43 citation statements)

References 4 publications

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“…For this work, we initially focus on Uganda where 58% of deliveries occur at home [33] and an estimated 6,300 women die each year from maternal-related complications [34]. The Ugandan government supports using portable ultrasound units to help combat maternal mortality [17] and has agreed to the UN Millennium Development Goals to reduce maternal mortality rates by three-quarters between 1990 and 2015 [23]. Overall, it is estimated that only 5% of all births in Uganda occur in facilities with emergency obstetrical care [23]; the expected percentage is at least 15% [30].…”

Section: Introductionmentioning

confidence: 99%

“…The Ugandan government supports using portable ultrasound units to help combat maternal mortality [17] and has agreed to the UN Millennium Development Goals to reduce maternal mortality rates by three-quarters between 1990 and 2015 [23]. Overall, it is estimated that only 5% of all births in Uganda occur in facilities with emergency obstetrical care [23]; the expected percentage is at least 15% [30]. Similarly, Caesarean sections should account for between 5% to 15% of all expected births in a typical population [30], but in Uganda only 1% of births are Caesarean deliveries [23], possibly indicating that pregnancy conditions are not being properly detected in time to take precautions.…”

Section: Introductionmentioning

confidence: 99%

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Portable antenatal ultrasound platform for village midwives

Brunette

Gerard

Hicks

et al. 2010

Proceedings of the First ACM Symposium on Computing for Development

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Ultrasound imaging is an effective tool for identifying maternal mortality risk factors. Unfortunately, ultrasound is nearly absent in many rural healthcare facilities in developing regions due to the high costs of both equipment and required training. To leverage existing healthcare systems commonly found in these contexts, we have focused our efforts on increasing the diagnostic capabilities of midwives -often central medical figures in rural and lowincome communities. We have designed and built a low-cost portable ultrasound device consisting of a USB ultrasound probe and a touchscreen netbook for a total cost of around USD3500. Compared to currently available ultrasound devices, we simplified the user interface while maintaining functionality to allow midwives to detect three common obstetrical conditions: placenta previa, multiple gestations, and breech presentation. To evaluate our solution, we tested the accuracy of ultrasound measurements, image quality, and whether midwives could use ultrasound. Testing performed by nine clinicians indicated our device would be appropriate for identifying the three conditions. Our modular design approach allows for easy modification, and the device is designed to utilize existing local healthcare resources in order to create a sustainable solution that does not depend on continuous foreign assistance.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Portable antenatal ultrasound platform for village midwives

Brunette

Gerard

Hicks

et al. 2010

Proceedings of the First ACM Symposium on Computing for Development

View full text Add to dashboard Cite

show abstract

“…Most of these programmes use healthcare-worker training as the point of departure. They are often embedded in safemotherhood-type programmes [16] or sector-wide approach (SWAp) initiatives [17]. Some of the more well-known programmes are Advance in Labour and Risk Management (ALARM) [18], Making It Happen [19], Practical Obstetric Multi-Professional Training (PROMPT) [20] and ALSO (Advanced Life Support in Obstetrics) [21].…”

Section: Programmesmentioning

confidence: 99%

“…Political and administrative figures, health professionals and communities must all be aware of the problem of perinatal and maternal mortality and the options for EmONC [17,43,44].…”

Section: Awareness Across the Boardmentioning

confidence: 99%

“…Orinda et al [17] describe a sector-wide approach (SWAp) bringing together stakeholders from government through to civil society and facilities to use an assessment of United Nations (UN) process indicators to "establish a baseline for availability, utilization, and quality of EmONC" (p 285). Meeting many of the outcomes within an EmONC programme requires material resources (e.g.…”

Section: Resourcesmentioning

confidence: 99%

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What is needed for taking emergency obstetric and neonatal programmes to scale?

Bergh

Allanson

Pattinson

2015

Best Practice & Research Clinical Obstetrics & Gynaecol

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Scaling up an emergency obstetric and neonatal care (EmONC) programme entails reaching a larger number of people in a potentially broader geographical area. Multiple strategies requiring simultaneous attention should be deployed. This paper provides a framework for understanding the implementation, scale up and sustainability of such programmes. We reviewed existing literature and drew on our experience in scaling up the Essential Steps in the Management of Obstetric Emergencies (ESMOE) programme in South Africa. We explore the non-linear change process and conditions to be met for taking an existing EmONC programme to scale. Important concepts cutting across all components of a programme are equity, quality and leadership. Conditions to be met include appropriate awareness across the board and a policy environment that leads to: commitment, healthsystems-strengthening actions, allocation of resources (human, financial, capital/material), dissemination and training, supportive supervision, and monitoring and evaluation.

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Programme alignment in higher‐level planning processes: a four‐country case‐study for Sexual and Reproductive Health

Dodd¹,

Huntington²,

Hill³

2009

Health Planning & Management

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With international development assistance focussed on poverty reduction, national and sector-wide planning processes have become increasingly important in setting agendas. Sector-Wide Approaches (SWAps), Poverty Reduction Strategy Papers (PRSPs), and other higher level planning processes, including Millennium Development Goals (MDGs) reporting, have required new levels of engagement in national and sectoral planning processes. For Sexual and Reproductive Health (SRH), this has had mixed consequences, despite raising the profile of SRH in national planning agendas, and emphasizing the potential of SRH to contribute to the reduction of poverty.Drawing on case-study research from four countries, this paper analyzes alignment of SRH policy with higher-level planning processes. It found that SRH managers are rarely engaged in higher-level planning processes, and while SRH features prominently in the [health] sections of PRSPs, it is not reflected in other sections, and does not necessarily correspond to more resources. Despite these limitations, these planning processes offer synergies that could improve the contribution of SRH to health sector development and poverty reduction. The paper recommends that local donor organizations, including key UN agencies, offer greater support for SRH programme managers in promoting the pro-poor and systems-wide strengths of SRH programmes to planners and policy makers.

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A sector‐wide approach to emergency obstetric care in Uganda

Abstract: By using the data from the assessment, it was possible to influence national policy through the health sector-wide approach (SWAp) and place EmOC high on the national agenda. A national strategy and roll out plan to strengthen EmOC is now in place.

Cited by 33 publications

References 4 publications

Portable antenatal ultrasound platform for village midwives

Portable antenatal ultrasound platform for village midwives

What is needed for taking emergency obstetric and neonatal programmes to scale?

Programme alignment in higher‐level planning processes: a four‐country case‐study for Sexual and Reproductive Health

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