Village health teams, key structures in saving mothers and their babies from preventable deaths

Reaching the most deprived in remote Karamoja

Proscovia Nakibuuka Mbonye with contributions from Martin Ngolobe
maternal and newborn health in Uganda
UNICEF Uganda/2018/Adriko
13 August 2018

Emmanuel Akiro Lochop, a Village Health Team (VHT) member sits in front of his house in Apetolin West village, Lokopo sub county, Napak District, as he peruses through a voluminous VHT register. A register he later explains, keeps records of pregnant mothers and newborns in his catchment area. He and 12 other VHT members cover 20 villages and he is their supervisor.

As per the register, he is supposed to visit Angelina Nawal, a 20-year-old mother, expecting her second child in a few weeks. She is 35 weeks pregnant and her due date is close.

Lochop visits such pregnant mothers regularly to encourage them to attend antenatal care visits, give birth in health centres, watch out for any danger signs in pregnancy like bleeding, swollen feet, etc, encourage husbands to support them during the pregnancy as well as encourage mothers to return to health facilities for post-natal care at 6 days, 6 weeks and 6 months. Lochop together with 634 other VHTS in Napak District, obtained  all this knowledge and skills from a UNICEF-supported training on  community newborn care conducted by CUAMM with financial assistance from the Korean International Cooperation Agency (KOICA).

Lochop who has been a VHT since 2008 affirms that the UNICEF training was useful.

"I now know when a pregnant woman is in trouble. I know the danger signs. When I see them, I quickly take the mother myself or refer her immediately to the health centre. This has saved many mothers and babies,"

Nawal is happy to see Lochop, who is visiting her for the third time in her pregnancy. Lochop educates her about the benefits of delivering at the health facility and reminds her to watch out for any labour signs since she is due soon. He commends her for attending the ANC visits which enabled the doctor check her and the unborn baby. 

“Before we were equipped with this knowledge, we never cared about our pregnant mothers in the communities. Many gave birth in the communities with support from Traditional Birth Attendants (TBAs) and many died together with their babies due poor care and the cold." 

But today, Lochop utilizes the register to follow up all pregnant mothers, he knows them by name, knows who is due to deliver when, he knows the ANC dates for each mother and this helps him monitor them closely. In June alone, he supported four pregnant women who gave birth successfully at the health centre.

His role as a VHT does not stop at monitoring pregnant women alone. The KOICA funded training also provided him with skills that enable him monitor mothers after delivery. During such visits, he checks on the status of the newborns, healing of the umbilical cord, encourages mothers to breastfeed, as well as watch out for any danger signs among the mothers and the newborns. In case for any complications, he makes the necessary referrals.

As a result of their efforts, Lochop and other VHTs have contributed to the improvement of the maternal and child health indicators of Napak District. For instance, the ANC 1 coverage has increased from 65 per cent to 96 percent, ANC 4 from 28 per cent to 48 per cent, health centres deliveries from 31 per cent to 64 per cent and post-natal visits at 6 days has risen from 16 per cent to 35 per cent in a period o 3-4 years.

"The services offered by Lochop in the communities strongly address the first delay in making quick decisions to seek medical services for pregnant mothers and newborns. With the continuous checkups and reminders by Lochop, many pregnant mothers and babies have been identified and referred to health centres and saved," says Regina Narus, Assistant District Health Officer in charge - maternal health, Napak District

Lochop also known as ‘Piripiri doctor’ by the community loves what he does.

"I have seen many mothers and babies die in the past. I don’t want to see or hear about any more deaths. That’s why I do what I do- save mothers and their babies."

Lochop ends
maternal and newborn health in Uganda
UNICEF Uganda/2018/Adriko
Lochop visits Lawal to check on her progress during pregnancy