|Date Posted||July 31, 2020|
Training and Consultancy
Regional EmONC Consultants, Gulu, Uganda
Organization: University Research Co. (URC)
Currently in Uganda, 18 women die every day due to pregnancy-related complications, with over 90% occurring around childbirth. The Acholi region experiences high institutional maternal mortality of 89/100,000 deliveries. The leading direct causes of death include hemorrhage, sepsis and hypertensive disorders of pregnancy.
Uganda's neonatal mortality rate has remained relatively static at 27 per 1,000 live births, which represents nearly one half of all deaths in the first year of life (56 deaths per 1,000 live births). The leading causes of newborn mortality are Birth Asphyxia, prematurity and Newborn infections. Experience from MPDSR in Acholi regions shows limited skills of health workers in identifying and managing newborns complications a critical underlying factor.
Capacity assessment conducted in 2018 in 75 sites with the highest maternal and perinatal mortality burden in Acholi revealed service delivery systems gaps that greatly affect delivery of quality RMNCAH services for all mothers and newborns. There were Inadequate EmONC (BEmONC and CEmONC) services especially due to Skills gaps among health workers across the RMNCAH continuum. For example, of the 346-staff assessed, only 24% had had a BEmONC training, 21% Newborn resuscitation training in the last 12 months. This is in addition to lack of updated national guidelines and job aides (only 38% with BEmONC guidelines, 78% PPH and 56% pre-eclampsia/Eclampsia).
Limited knowledge, skills and competences in management of maternal, newborn and childhood (MNCH) complications curtails healthcare providers' ability to anticipate, recognize, manage or prevent complications that are associated with high morbidity and mortality. The health provider competences could be improved through in-service integrated mentorship approach.
In a bid to address the skills and performance gaps within the region, especially as regards emergency obstetric and newborn care, RHITES-N, Acholi plans to identify a competent team of regional specialists with capacity to offer on-site skills training on Emergency Obstetric and newborn care, Newborn resuscitation, and Maternal and perinatal Death Surveillance in Acholi subregion. This engagement will also include onsite hand-on mentorship towards developing sustainable quality MNCH services including identifying and managing Obstetric and newborn emergencies, newborn resuscitation, Maternal and perinatal death review and newborn infections in the RHITES-N, Acholi sub-region.
To improve capacity of health workers on providing Emergency Obstetric Care and care for the sick newborns.
Consultancy objectives: Describe the overall objectives of the consultation
To offer practical skills mentorship on management of obstetric and newborn complications with focus puerperal sepsis and newborn infection prevention and management in the RHITES-North supported health facilities
Review MPDSR tools, functionality of MPDSR committees and offer tailored mentorship on use of MPDSR and BABIES Matrix at 25 health facilities
Support facilities to implement clean clinic approach at 25 high volume facilities
Specific tasks: Explain in detail the tasks that the consultant must completed
Develop an integrated data collection and mentorship tool covering quality of care indicators in maternity, Theatre, NICU, KMC and PostNatal units
Conduct integrated hands-on mentorship at 25 high volume facilities focusing on EmONC, Essential newborn care, care for sick and premature newborns and MPDSR
Support 25 high volume facilities to document root cause analysis of puerperal sepsis and newborn infections, and work with the team to address them.