All of our K4C projects are negotiated with local stakeholders and are designed to take into account the needs of the local health system and communities, focusing on quality improvement and long term sustainability. Of course funding is critical; we rely heavily on external project funding to finance our projects so the demands of the funding body can also dictate or direct our activities. We often run a number of projects simultaneously; more information about some of our main current projects can be found below:
Kataraka Health Centre
Kataraka health centre is located just outside of Fort Portal in a densely populated area. Kataraka has the potential to provide midwifery care to many mothers and babies in the local area but due to a number of factors, it has been unable to do so. Seeing that mothers were not accessing Kataraka for intrapartum or postnatal care, Knowledge for Change sought to improve capacity and infrastructure within the health centre. A long term midwifery volunteer undertook outreach activities with local staff in order to find out why women were bypassing their local health facility in order to deliver at the large regional referral hospital. Often the referral hospital is overcrowded with poor resources and minimal staff and in order to decongest the regional hospital, smaller units such as Kataraka must be made accessible to mothers and babies. During the outreach activities many women sited privacy as a key concern due to antenatal activities occurring in the labour room. Most alarmingly, local mothers mentioned that the midwives were not in attendance at night and therefore many mothers did not want to risk going there once in labour. Through conversations with midwives other concerns were noted, such as a lack of a staff room, poor layout in the postnatal area, security and cleanliness.
The work at Kataraka is ongoing with long-term volunteers working to improve the health centre for mothers and their infants. Training days have taken place to increase confidence and teamwork amongst the midwives. There is now running water in the maternity department and the entire health centre has been painted. Knowledge for Change volunteers have introduced a baby clothes project which seeks to incentives mothers to deliver at the unit through donations of baby clothes. The lay out has been completely changed and whilst space is still limited, mothers no longer cite privacy as a concern. A room has been utilised as a staff room and has been painted and cleaned to ensure midwives work night duties. Lights have been put up at the centre and a fence is to be erected soon. Deliveries at Kataraka have been around two to three on average per month. Since Knowledge for Change has been involved at the centre deliveries have increased from eleven in October to sixteen in November. The local community is overwhelmingly positive and the midwives feel valued and keen to build on their successes. We hope the delivery rate will continue to increase!
Hand Hygiene Project
Anti-bacterial hand gel is expensive in Uganda and as a result Health Centres struggle to afford it and with many centres having no sufficient water supply it can be hard to maintain good standards of hand hygiene.
At Knowledge for Change we have set up our own lab making hand gel in accordance with the World Health Organisation outline and provide this to Health Centres in the region at no cost. Over time, once we have trained staff on proper hand hygiene and the benefits of using hand gel, we hope to sell it to the health centres at a low cost to make the project sustainable for both the charity and for the health centres as a form of social enterprise.
Kagote Health Centre
Knowledge for Change began working with Kagote Health Centre in July 2014. Previously to this the Centre hosted ART clinics and general outpatient and ante-natal clinics but did not have the necessary equipment to deliver babies. Knowledge for Change provided the facilities that staff requested and in November 2014, Kagote had its first delivery in over 16 years. Since then, demand has increased substantially and it is currently delivering an average of 48 babies per month.
Knowledge for Change has carried out the following work at Kagote Health Centre:
- Created a placenta pit
- Created a kitchen for patients and their families to use
- Fixed plumbing and put in three sinks
- Tiled the floors in maternity
- Separated a room into two sections to allow 2 labouring women at one time
- On-going provision of baby clothes
- Opportunity for Kagote midwives to study in the UK
- Provided clinical volunteers
- Employed a midwife
- Created a rest room for midwives complete with a bed, kettle etc.
- Provided a sterilisation cooker
- Decorated the maternity building
- Provided beds
- Built a waiting room for outpatients
Some update reports on our Cervical Screening and Treatment Programme at Kagote can be found below: