Maternal, Newborn, and Adolescent Health

By 2016, Uganda hosted 500,000 persons displaced by conflict. Of these, 83,000 live in Kampala, 51% are female aged 15-49 years old women were disproportionately affected. Kampala’s urban refugees live in slums of Katwe, Makindye and Masajja. Urban refugees have poor access to Sexual and Reproductive Health (SRH), and Family Planning (FP) services, due to transportation, education, culture and language barriers within a weak health system, not tailored to deliver SRH, and FP services.

Every year in Pakistan, half of 8 million pregnancies are unintended; 25% (2.2 million) end in induced abortion. Midwives with limited training perform half the abortions. Quality Post-Abortion Care (PAC) is lacking. 700,000 women experience complications contributing 12% of maternal deaths. Midwives need improved knowledge and skills to improve access to family planning, safe abortion and improved PAC, which in turn will improve lives of women and decrease demands on the health system.

Puerperal sepsis is the second leading cause of maternal mortality after postpartum hemorrhage accounting for 15% of maternal deaths.At Mbarara Regional Referral Hospital(MRRH) in Uganda, puerperal sepsis was found to be the leading cause of maternal mortality accounting for 30.9% of maternal deaths (1).The prevalence of wound sepsis following cesarean delivery is 15.5%.At MRRH, the rate of C-section was estimated to be 25% in 2011 which is higher than the 15% rate recommended by the WHO.

Health facilities at county level in Uganda provide care to majority of Ugandan newborns because of their easy accessibility yet they have no specialized health workers such as pediatricians. This has kept neonatal mortality high. We developed PRISMS an SMS based remote decision support system that uses routine newborn assessment findings to provide suggestions for appropriate comprehensive management for sick newborns at the level of a specialist based on a clinically validated algorithm.

Preeclampsia and eclampsia are the second leading cause of maternal mortalities worldwide,complication that can result in serious or fatal complications for both mother and unborn child. Early symptoms are subtle,so women are often unaware of their complication unless they receive routine prenatal care or their condition develops into eclampsia. In Uganda , most women do not have access to routine prenatal care and are unable to seek medical care before the complication becomes detrimental

Postpartum Hemorrhage (PPH):Defined as the loss of more than 500 ml or 1,000 ml of blood within the first 24 hours following childbirth. PPH is the leading cause of maternal mortality in developing countries and Africa as a whole. Amidst the mushrooming approaches to overcome this condition, Globally it still occurs about 8.7 million times and results in 44,000 to 86,000 deaths per year making it the leading cause of death during pregnancy, thus a global concern.

Develop a portable electronic partograph (e-partograph) based at a PHC centre synchronised with a hospital-based monitor. The e-partograph will be plotted to monitor foetal heart rate, cervical dilation, descent of the presenting part, contractions and blood pressure. Deviant trends will be flagged with an alarm system with a link to algorithms for alternative actions accessible to the health worker.

Haiti is a dangerous place to be pregnant. The risk of dying in childbirth is 1 in 80 and less than 25% of pregnant women delivery their babies in a health facility. Women face significant barriers to safe pregnancy and delivery, and babies are at risk for malnutrition and disease. These barriers are often due to a lack of access to care, but are also behavioral.

East Africa has the highest incidence and mortality from cervical cancer in the world, where the mortality rate is 50%. Screening programs have been successful in high-income countries based on pap smear testing. There exist several barriers to the uptake of screening in Kenya, namely access to a clinic, access to personnel that can interpret the samples, as well as the cultural and social barriers to cervical exams. Currently less than 4% of at-risk women in Kenya are undergoing screening. We have developed an innovative tool to make self-screening for cervical cancer possible.

This bold idea aims to integrate a locally produced HBsAg diagnostic test kit for screening of antenatal clinic (ANC) mothers in Kenya. Patients visiting public and faith-based health facilities form the majority and most vulnerable, yet they do not have their HBV status checked during ANC profiling. These weak diagnostic systems in our country creates a gap between patients and treatment.