Improving access to maternal health services for women

Demand side financing is a tool that is being utilized to improve the utilization of under used services among the poor and under-served populations by placing purchasing power as well as choice of provider directly in the hands of the recipients (World health Report 2010).

This is an important innovation in health care systems where access remains poor and therefore the utilization and uptake of services very low among those who would benefit most from these services, that is to say the poor and vulnerable sections of the populations.

This is especially true for services such as family planning, maternal health and child health.

The writer is the head of communications and public relations at the Marie Stopes Uganda - Faith Kyateka

Every year there are 1,600,000 pregnancies in Uganda and many of these pregnant women face the probability of living or dying while giving life. – Faith Kyateka

Every year there are 1,600,000 pregnancies in Uganda and many of these pregnant women face the probability of living or dying while giving life. According to the World Health Statistics report 2015, maternal mortality is at 320/100,000

Matched with the poor health seeking behavior (less than half of Ugandan women deliver with a skilled attendant) the need for a demand side intervention that actively engages both the private and public sector is clear.

In Uganda various demand side financing interventions have been tried which involve the use of subsidies or vouchers.

Voucher schemes like the Uganda Reproductive Health Voucher project implemented by Ministry of Health with Marie Stopes Uganda as the voucher management agency, are designed for women of reproductive age living below the poverty line.

Community health workers sell the voucher to pregnant women that entitle poor women to attend to skilled care during pregnancy, delivery and post-natal period in South Western and Eastern Uganda.

In this case a voucher is a document that authorises payment of a health service; therefore, it is a token that can be exchanged for a pre-defined set of health services or products. The voucher enables public subsidies for services or products to follow the client rather than being tied to providers.

The voucher system which is aimed at boosting maternal health services in 240 health facilities is being implemented in 25 districts of south west and eastern parts of the country.
Since the project started in April 2016, 65,000 expectant mothers have benefited from the project.

Specifically a total of 32,000 babies have been delivered to women from a socio-economic group that had a very low rate of uptake of maternal health services prior to the project. The demand for the voucher continues to be very high often exciding supply.

Dr. Michael Bukenya (chairperson of the health committee of Parliament) says that the voucher project proves that health financing is possible and therefore provides good lessons and benchmarks for the National Health Insurance Scheme which has been under review for a long time.

In conclusion, demand side financing projects particularly vouchers have proved to be effective in enhancing people’s motivation to seek for health services, improving health system performance and boosting facility deliverables as well as skilled birth attendance thereby contributing to the reduction of maternal mortality.

These services should be widely available to pregnant women in low resource settings. Therefore, as we mark International women’s day, It is critical that every pregnant woman and new-born has access to and receives good quality care and life saving interventions around the time of birth.

The writer is the head of communications and public relations at the Marie Stopes Uganda

#IWD2017: LET GIRLS AND WOMEN TAKE A SEAT AT THE TABLE

#Beboldforchange is a tagline for International Women’s day which is marked every year on March 8. This theme gears us to all be responsive and responsible leaders in creating a more gender inclusive world where women and girls have quality education, health care, decent work, access and ownership rights over property and technology and equal participation in political and economic decision making.

The Minister Dr Jane Aceng with some of the key staff of Marie Stopes

The Minister Dr Jane Aceng with some of the key staff of Marie Stopes

According World Economic Forum, gender gap won’t close entirely until 2186. This gender disparity is due to some factors like women being underrepresented in the government, they are the minority in the booming tech sector yet still shoulder more in the household burden and having a greater risk of rape and domestic violence. Are we therefore going to seat, cross our arms and wait for a decade and yet many women in Uganda face a wide range of challenges like discrimination and lack of economic self-sufficiency which has led to gender based violence, limited access to health care and family planning leading to maternal and neonatal mortality and limited resources for the girl child to be in school.

To address these gaps, we need to learn from and replicate projects that have worked well to empower women; these include but are not limited to subsides for women, investment income generating activities, supporting girls stay in school among others.

One such project that Maries Stopes is implementing is the Uganda Reproductive Health Voucher Program. This is a 4 year Ministry of Health project aimed at increasing access to skilled care among poor women living in rural and disadvantaged areas during pregnancy and delivery. This project has empowered many less privileged mothers in Uganda to uptake antenatal care and safe delivery services thus strengthening institutional capacity to deliver reproductive health services to women and girls.

Therefore, to have more girls and women at the table, we must commit to advancing women and bring about change that is directly and aggressive reaching out to other women through coaching programs and initiatives; we need to identify the right forums which empower women socially, economically and also their health. We need to strengthen investments in service provision and advocacy more especially to health and family planning contraceptives, and a right to education for the girl child.

 

By. Mahoro Rose, Sexual Reproductive Counselor, Marie Stopes Uganda

#40YearsMSI: Marie Stopes International celebrates 40 years

 Background – About MSU

Marie Stopes Uganda is the largest and most specialized private provider of SRH services. MSU delivers services through a mutually-reinforcing, multi-channel approach to maximize impact and expand access.

What is the 40 years about?

This November, Marie Stopes International will be celebrating 40 years as the world’s largest provider of  high quality and affordable Reproductive Health Services.  #40YearsMSI

MSU has remained the provider of choice of Maternal and Reproductive Health Services for Ugandan women and men.  We continue to be deeply committed to our clients and therefore continually evolve to give them the best experience, and highest standard of clinical quality.

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What is MSU providing the public?

In celebration of the 40 years, MSU has decided to give back to its clients through providing free Family Planning services at all our centers on 4th and 5th November 2016.

Why Family Planning?

MSU strongly believes that Family Planning is one of the most cost effective ways to reduce maternal, infant and child mortality.

Family planning improves the lives of women and children.  When parents space their births at least 3 years apart, children are less likely to get sick and more likely to survive beyond their 5th birthday; and women are less likely to have complications during childbirth.

Using family planning to delay the next pregnancy also allows the mother to pay attention to her children.  This is the best way to prevent accidents and injuries.  Children who are well looked after also usually eat better, are cleaner, and develop better both physically and mentally.

 What FP methods shall we be providing?

  • IUD or Coil: This is a long-term method that is effective for up to 12 years.  The coil is a small plastic T shaped wrapped with some copper wire that is inserted into a woman’s womb by a trained health worker.
  • Pills: Women can take a pill every day that contains a hormone that stops her body from releasing an egg each month.   Once she stops taking pills, her ovaries will begin releasing eggs each month again.
  • Injectables: A woman can take the same medicine that is contained in the pill through injections.  Each injection is good for 3 months.  So, the woman needs to return for an injection every 3 months.  When the woman wants to get pregnant again, she should stop the injections.
  • Implants: The same medicine that is contained in the injectables and pills in contained in 1 – 6 small plastic capsules.  A doctor or nurse inserts these capsules under the skin of a woman’s upper arm.  When the woman wants to get pregnant, she can have the implants removed.  Soon afterward, she will be able to get pregnant again.

Permanent Family Planning Methods:

  • Vasectomy: A doctor ties and cuts the tubes that carry sperm from the testes to the penis.  So, the man can still perform sexually, but his semen will not have any sperm.  So, he will not be able to make a woman pregnant.
  • Tubal ligation: This is a permanent family planning method for women.  A doctor ties and cuts the tubes that carry the eggs from the ovaries to the womb.  So, when the woman has sex again, the sperm will not be able to meet with the egg.  The woman will continue to menstruate as before.  But, she will not be able to have children.