Cornety Nakiganda Kivumbi, H2H Programme Lead, joyfully carrying one of the twins during a home visit, accompanied by the entire H2H Programme team, including Nasuuna Jesca (VHT) and Seela Margret
A latest study titled “Assessing the Feasibility and Acceptability of High-Risk Infant Follow-Up in a Rural Setting in North Central Uganda” has revealed that the Hospital-to-Home (H2H) model has the potential to improve maternal, newborn, and sickborn health outcomes with exclusive breastfeeding rates increasing from 6.6% to 42%, and vaccination completion rates rising from 76.9% to 88.5% while ; also strengthening caregiver engagement and shifting community perceptions about the survivability of small and sick infants.
The Hospital-to-Home (H2H) model is one of the key interventions under the Uganda Newborn Programme, which is being implemented by Adara Development Uganda with support from ELMA Philanthropies with an aim to build capacity within communities to support small and sick newborns after hospital discharge.
A major component of the H2H model is the training and equipping of Village Health Teams (VHTs) to mobilize communities and conduct postnatal care home visits within three days of the newborn’s discharge. These visits are crucial for ensuring that mothers and their babies continue to receive vital care, information, and support during the critical first few days at home
According to Beatrice Niyonshaba, Deputy Director of Maternal, Newborn, and Child Health at Adara Development this model could be game changer in Newborn Health.
‘’In Uganda, many families struggle to return for follow-up visits due to cost, transport challenges, and lack of caregiver awareness. The H2H model addresses this by involving caregivers early, equipping them with knowledge on newborn danger signs, and ensuring post-discharge follow-up through community health systems.
“The model not only reduces post-discharge mortality but also builds trust and ownership among families, which is critical but often an overlooked aspect of newborn survival in low-income settings. ‘’We also run regular community sensitization and awareness initiatives about the causes and survivability of small and sick newborns, preventative measures, as well as the services”. The model was initially piloted at Kiwoko Hospital, with strong support from both healthcare staff and the community. This phase allowed for continuous refinement and strengthening of the model, ensuring it met the needs of both families and healthcare providers.’’
‘’We believe H2H has the power to improve outcomes for mothers and babies across Uganda and beyond. With this in mind, together with the MoH, we are adapting the programme for the Ugandan public health system.
‘’Currently, the model is being implemented in Nakaseke hospital, a government facility. This will provide insights for scale up to other government facilities. The programme has seen tremendous success due to the engagement and motivation of CHWs, who are provided with incentives, extensive training, and ongoing support. Regular check-ins and monthly meetings ensure these workers remain accountable and connected to the Programme’s objectives.’’
Ms. Beatrice Niyonshaba, Deputy Director of Maternal, Newborn, and Child Health at Adara Development
In terms of success of the model, Dr. Monica Okuga and Prof. Peter Waiswa, the Uganda Newborn Programme team lead from Makerere University School of Public Health (MakSPH) attribute it to its community-based approach, involvement of local leadership, and the strong involvement of trained VHTs leading to local ownership
According to most recent UN annual estimates, Uganda records 62,000 deaths around the time of birth. Of these, 32,000 are neonatal deaths, 26,000 are stillbirths and 4,800 are maternal deaths. Majority of the newborn deaths occur within the first week after delivery- a period considered very vulnerable for both the mother and baby.
To contribute to addressing this challenge, a coalition of institutions including; Makerere University School of Public Health, Baylor Foundation Uganda, Adara Development Uganda, Nsambya Hospital, and the Ministry of Health with funding from ELMA Philanthropies launched a national health systems strengthening initiative known as the Uganda Newborn Programme (UNP) in 2022. This program uses a regional approach to improve newborn care in three regions of Uganda namely Kampala, North Central and Western regions.
By July 2025, the programme aims to reach 120,000 small and sick newborns, with a target of reducing newborn mortality by 40% in the targeted areas