Proposal
for summer internship with Christ the King Medical Unit and Maternity Home
Bulumaji
Trading Centre, Uganda
By
Anisha Moore Johnson, Intern, San Francisco State University
_________________________________________________
Introduction:
Currently
Uganda is leading Sub-Saharan Africa in HIV/AIDS prevention work. The country
has been recognized locally and nationally for their successful community-based
programs that address the epidemic. While Uganda is winning the fight against
HIV, still among
13–25 year-olds in Uganda, women are six times more likely to be infected than
men (ACP, 1998), for reasons that are partly biological and partly
socio-cultural. Each
year more than 500,000 women, in developing countries, lose their lives to
preventable complications of pregnancy and childbirth.
Infectious
diseases such as Malaria, Tuberculosis, and Influenza plague the lives of
pregnant and post-natal women and infants (UNAIDS,
2005). There are many questions that are unanswered concerning the health and
well being of Ugandan women. Despite free and reduced preventative treatment,
why are pregnant and post-natal Ugandan women not accessing care? In a recent
study conducted by the Makerere University,
Kampala, Uganda, the study found that when examining adherence to
traditional birthing practices and beliefs, pregnancy is a test of endurance and
often leads to maternal death; such a sad but frequent outcome often occur.
The
use of primary health units and the referral hospital, including when
complications occur, was considered only as a last resort. Lack of skilled staff
at the primary health care level, complaints of abuse, neglect and poor
treatment in hospital and poorly understood reasons for procedures contribute to
the unwillingness of women to seek care for complications. (Department of Women
& Gender Studies, Makerere University, Kampala, Uganda). Additionally, the
socio-cultural aspect is an inherent part of the choices and decisions Ugandan
women make when accessing preventative healthcare.
Ugandan
society is patrilineal (Kaleeba et al.,
1991;Obbo, 1995) and women are therefore subject to their fathers and then later
to their husbands. Female subservience is accepted by most men and women (Obbo,
1995). It is these factors that greatly impact the health of the Ugandan mother,
and lay the background for important public
health work to address these issues.
History
:
Christ
The King Medical Unit and Maternity Home is a non-governmental organization
(NGO) that was started in May 1986. The agency was established to address the
community health needs and improve the quality of life of rural communities in
the Mukono District of Uganda. Today the agency serves local women and infants
from neighboring districts that are affected by HIV, Malaria, and many other
infectious diseases. The agency operates under the goal of reducing maternal and
infant mortality and morbidity.
Mission: Unknown
Programs and Services:
Christ The King Medical Unit and Maternity Home works to achieve
the goal of reducing maternal and infant mortality by providing maternal and
child health care services, information and counseling services, STD and
HIV/AIDS health education, building partnerships with local community members,
increasing awareness to pregnant women on receiving immunizations for infectious
diseases.
Population
Served:
The
agency offers outpatient medical services to pregnant women and new mothers and
infants in the Christ The King Medical Unit and in rural villages.
To
assess the knowledge, beliefs, and barriers to preventative treatment for
infectious diseases among rural Ugandan mothers in the Mukuno District of
Uganda.
Methods:
Key
Informant Interviews
The intern will conduct four Key Informant
interviews with international program-clinic liaison, clinic program
coordinator, midwife, and nurse.
Mom
empowerment workshops
The intern will facilitate two thirty
minute mom empowerment workshops, that focus on the challenges of being a new
mom, ways moms in the group handle those challenges, healthy activities for
rural mothers to do with their baby, and sharing healthy information and support
among moms in the group. All workshops will follow a weekly immunization clinic
and will fill allotted outreach time within the clinic. The mini workshop will
be used to strengthen knowledge of health concerns of new mothers and as a tool
for the intern to acknowledge health challenges, build trust, and comfort level
among women participants. Key will
be quickly, on the scene, to assess and include local customs, traditions and
ways of thinking inherent to the population served.
Face-to-face
surveys
The intern will conduct seven to ten
face-to-face quantitative surveys with supporting qualitative questions. The
qualitative questions will be used to inquire about the specific barriers and
beliefs of women to accessing preventative treatment for infectious diseases.
The criterion for participation is that women must be clients of Christ The King
Medical Unit and are pregnant or have given birth within the last two years. The
participants will be asked about their knowledge of infectious diseases and
treatments, beliefs surrounding infectious diseases and preventative treatment,
and the barriers to accessing preventative care for infectious disease
treatment. Each interview will be tape-recorded, quantitative data collected
will be inputted into database and will be coded for emerging themes. The
surveys will be offered in English and can be orally translated by clinic
midwife based on need.
Key
Questions
1.
What knowledge do women have about infectious diseases and treatment?
2.
What beliefs do women have about infectious diseases and treatment?
3.
What barriers do women face to preventative treatment for infectious
disease?
4.
What knowledge and beliefs do clinic staffs have about barriers to
preventative health care among rural Ugandan mothers?
Goals and Objectives:
Goal:
All
women clients of Christ the King Medical Unit and Maternity Home in Mukuno
District, Uganda will experience no barriers to preventative treatment
compromising a safe pregnancy and childbirth
Outcome
Objective:
By June 2007, 10% of pregnant and post partum women clients will receive
prevention treatment for a infectious disease at Christ The King Medical Unit
Impact
Objective:
By June 2006, 15% of women in Christ the King Medical Unit will have increased
knowledge of preventative treatment for infectious diseases.
Impact
Objective:
By June 2006, 50% of Christ The King Medial Unit Staff will be able to identify
at least two barriers and or beliefs of rural Ugandan women
Process:
By June 2006, intern will conduct two informational mom empowerment workshops
that will address healthy prevention methods for new moms.
Process:
By June 2006, intern will conduct four key informant interviews with clinic
providers and staff
Process:
By August 2006, intern will analyze data and develop report recommendations
A
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