Saving Lives at Birth Uganda Project

Each year, approximately 350,000 mothers and up to two million babies die during pregnancy or on the day of birth. In response, Jhpiego is utilizing an integrated approach to saving lives by building the capacity of all providers who care for mothers and newborns to ensure they have the skills to prevent and rapidly respond to postpartum complications. We use a low-dose, high-frequency approach to learning and maintaining skills that is ongoing, facility-based, and focused on the entire team of providers in both remote health facilities and in the district hospitals that support them. We aim to equip and improve the skills and confidence of providers to manage both postpartum hemorrhage (PPH) and neonatal asphyxia at every birth. In addition, this approach will improve linkages of community facilities to the referral network, reducing delays that lead to poor maternal and newborn outcomes. Jhpiegos capacity-building effort, which is funded by the Saving Lives at Birth Consortium, targets health workers on-site, reducing absenteeism due to workshop trainings. Improving Service Delivery through Capacity Building Jhpiegos goal is to ensure all women and newborns receive lifesaving services in whichever facility they deliver and no matte r who attends them. Therefore, we have designed a package for all providers who attend births or are called on to manage complications, including midwives, doctors, nurses, clinical officers, nurses assistants, and any other cadre in the birthing team. Our capacity building and sustaining approach consists of: 1) training; 2) involvement of the frontline health team in care and peer support; and 3) reinforcement of learning through hands-on practice with simulators.

Providers practice with MamaNatalie during a Jhpiego training in Zanzibar

Through Jhpiegos twinned training, providers improve their skills and gain confidence in managing PPH and neonatal asphyxia by using realistic simulations without having to leave their workplace.

Twinned Training Modules for Capacity Building

Bleeding after Birth: Care for Mothers Bleeding after Birth is designed to prevent maternal deaths from PPH. In one day, providers are trained to provide active management of the third stage of labor, a highimpact intervention shown to decrease PPH by 60% and recommended by the World Health Organization to be used at all births to prevent PPH. The module includes rapid recognition and management of PPH using simplified protocols.

A peer provider uses the MamaNatalie birth simulator to practice with her team.

Helping Babies Breathe: Care for Newborns Helping Babies Breathe (HBB) is designed to increase newborn survival by improving recognition and basic management of babies who do not breathe at birth. HBB is an evidence-based curriculum in neonatal resuscitation, built on global protocols, that is adaptable to clinical and training use wherever babies are born. HBB focuses on routine care after a healthy birth, initial steps to help babies breathe after birth, ventilation with bag and mask, and ongoing care after birth.

A provider practices neonatal resuscitation on NeoNatalie

Innovation Recognizing that care for mother and baby must be integrated for the best possible outcomes and that the same provider is often alone, caring for both, Jhpiego will collaborate with our partners to provide frontline workers a capacity building and sustaining approach that improves their skills through targeted, low-dose, high-frequency training and practice, including: Two short training modules delivered at the workplace and centered on the moment of birth and immediate postpartum needs of mother and newborn

Regular team-based, clinically-embedded simulation practice conducted by peer providers from within the facility Use of innovative models for training and practice at the facility: Lrdals MamaNatalie and NeoNatalie