MakSPH, Uganda MoH extend newborn technical support to Mityana District

By admin June 4, 2023


The Maternal and Newborn and Child Health Centre of Excellence at Makerere University School of Public Health (MakSPH) recently supported the Uganda Ministry of Health’s National Newborn Steering Committee to train health workers in Mityana on essential newborn care, resuscitation techniques and care for small and sick newborns.

An assessment of neonatal care conducted in early 2023 in four facilities in Mityana district pointed to many challenges including inadequate health worker knowledge and skill in managing small and sick newborns, lack of designated spaces for kangaroo Mother care, poor infection prevention and control practices, lack of neonatal registers, lack of essential newborn care equipment, lack of designated resuscitation spaces, drug stock-outs among others.

The health facilities assessed were Mityana Hospital, Mwera Health Centre IV, Ssekanyonyi HC IV and Kyantungo HC IV.

This assessment was conducted by the Ministry of Health. Prior to this, leadership engagement meetings were held with the district leaders and health facility in-charges for purposes of ‘buy in’ and to involve them in the activities to be conducted.

It is against this premise that a newborn training and mentorship activity was organized by the National Newborn Steering Committee of the Ministry of Health. This activity was funded by the Uganda Newborn Programme, an initiative of the Elma philanthropies, through Makerere University School of Public Health (MakSPH).

This training and mentorship was conducted from 3 – 7 April 2023 at Mityana Hospital (main training site) and at the target facilities (mentorship sites).

 A total of 43 health workers were mentored, with the majority 44% (19) at the respective facilities visited and 35% (15) at the training site- Mityana Hospital board room (these were the primary targets).  

The training/mentorship team was led by Dr. Margaret Nakakeeto, the chair of the National Newborn Steering Committee. The attendees included nurses and midwives. Notably, medical officers were absent.

The activity aimed at improving frontline health workers’ knowledge and skills, adherence to neonatal guidelines and protocols, ensure the safety of babies during transportation to referral sites, establish a functional newborn data management system, establish/strengthen neonatal follow-up clinics, and create an enabling environment for newborn care through linkages with all stakeholders.

Overall, it focused on improving health workers’ knowledge and clinical skills in the management of small and sick newborns in order to contribute to the reduction of neonatal morbidity and mortality

A wide range of adult learning methodologies were employed including modified lectures, experiential learning, small group discussions, demonstrations and return demonstrations, clinical placement among others. A wide range of topics were discussed including HBB+, Equipment processing, care for the small and sick newborns, equipment use, infection prevention and control, breast feeding, thermal care, feeding, KMC and referral.

During the mentorship phase, the on-site health workers were mentored on equipment use, newborn care, data collection, analysis and use, and setting up neonatal units and resuscitation spaces. The health workers cleaned and re-organized the newborn care units and tested the equipment with the mentors.

The training/mentorship was successfully conducted with all the 4 newborn care units organized and ready to admit babies.

However, some recommendations were made: i) Allocation of nurse cadres to work in the newborn care units (NCUs) instead of midwives ii) District and health facility leaders should be more involved in governance of the NCUs iii) Regular mentorship of health workers to sustain skills iv) training of medical officers in newborn care iv) create demand for services by sensitizing community of the newborn care services provided.

This case study of Mityana district facilities is similar country-wide. Many health centre IVs in Uganda lack newborn care units even though they are mandated by policy to have one.

On the other hand, even though many government hospitals have newborn care units, their level of functionality is questionable. Currently, there is a strong drive by the Ministry of Health to improve newborn care country wide starting with the low hanging fruits such as training of health workers in essential newborn care and care for small and sick newborns; revamping newborn care units in all the hospitals; using a regional approach and multi-sectoral involvement.

If Uganda is to register great progress in newborn health, it is of utmost importance that the different partners/stakeholders in the newborn space form a coalition and implement interventions in tandem with the Ministry of Health as opposed to operating in silos or fragmented ways.

Compiled by Judith Grace Amoit