Strategies for increasing utilization of maternity services in Njeru, Uganda

Abstract

This paper describes the success of an ongoing community-based maternal and child health project in Njeru, Uganda. The project is a collaboration between the Njeru Town Council and an American university's social work programme and College of Nursing. The goal of the programme is to increase utilization of clinic-based maternity services i.e. pre-natal care and skilled attendant at delivery. Using community mobilization, education and capacitybuilding, community health workers (CHWs) were trained by the university-based nursing professors to educate the community about safe motherhood practices. Traditional birth attendants (TBAs) were trained by a nurse-midwife in techniques to reduce infection and maternal haemorrhage, the two main causes of maternal morbidity and mortality in the region. Over a 2-year span the clinic has doubled utilization of pre-natal services and more than doubled utilization of clinic-based labour and delivery services, resulting in more births at the clinic than by TBAs in the clinic's catchment area—an outstanding achievement in a country where more than 70% of women are assisted at birth by an unskilled attendant, including TBAs.