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Giving birth to my third child was not a nightmare

After giving birth to each of her first two children, 23-year-old Margaret Nabiddo would bleed uncontrollably. “I would bleed every day, for almost a month,” she says.

Her third delivery was different. While she was pregnant with her third child, Margaret was given a comprehensive clean delivery kit during her last trimester. This maama kit, distributed in communities in a pilot project under the Maverick Collective Project, included misoprostol and chlorhexidine. The two were added to the Ministry of Health – recommended maama kit to reduce on unpreventable maternal health deaths.

Misoprostol, taken after the delivery of the baby (with confirmation that there is no other baby), helps to control postpartum bleeding while the chlorhexidine is used for the care of the newborn’s umbilical cord.

“I got my maama kit from Deo [Village Health Team] who spoke to me about the importance of going for antenatal visits and delivering in a health facility,” the resident of Lwemivubo Village in Kiyuni sub-county, Mubende says. Margaret received her antenatal care from Kiyuni Health Center III.

“When I got into labour, I knew there was no way I could reach the hospital so I decided to carry my kit to the nearer Kakigando Health Center II. After I delivered my baby and the placenta, the midwife gave me the three tablets to put under my tongue.”

Margaret’s bleeding stopped after one week. It was a different experience from her earlier deliveries where she bled for almost a month.

Globally, postpartum haemorrhage (excessive bleeding after childbirth) is the leading cause of maternal deaths. In Uganda, over 24% of maternal deaths are due to uncontrolled bleeding after childbirth. It is recommended that mothers be given oxytocin which helps to limit bleeding by stimulating uterine contractions.

However, oxytocin is difficult to store as it requires refrigeration and therefore near impossible to have available in resource-limited areas. Misoprostol on the other hand, can be stored at room temperature with a shelf life of up to two years, and therefore easy to distribute in remote areas that are less likely to have refrigerators and reliable electricity supply.

The Maverick Collective project in Uganda focused on the availability of the misoprostol to mothers in these settings in order to reduce preventable maternal deaths. The project distributed the pilot comprehensive clean delivery kits in five districts of Uganda, identified alongside Ministry of Health, as those where maternal mortality was relatively higher than national average.

For women like Margaret, the addition of misoprostol made their postpartum experience a more enjoyable and safer period.

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PACE brings the MSD for Ugandan Mothers (MUM) project to a close

October 21st 2016 

More than 53,000 mothers have delivered safely in small, private-sector facilities over the last four years since the launch of the MSD for Ugandan Mothers (MUM) project. Through the MUM project, providers work to ensure that pregnant women—particularly those in remote and low-income communities—have access to affordable, quality maternal health products and services through the ProFam network of privately-owned franchise clinics.

This comprehensive project also works beyond the clinic setting by helping women overcome common barriers to care, such as cost, transportation and limited supplies. The MUM project includes 142 health facilities in 42 districts in Uganda—covering more than one-third of the country—and access to quality care which has impacted an estimated 130,000 women.

Recognizing the opportunity to improve maternal health in Uganda, the MUM project worked with small midwife-owned facilities that are often closest and therefore, the first facilities that mothers reach when in labor. The Programme for Accessible health, Communication and Education (PACE), the lead implementing partner of the MUM project, worked with many of these facilities since 2008 through its social franchise network, ProFam. The ProFam franchise is a network of private sector healthcare providers that provide high quality health services at affordable prices under a common brand.

To learn more about the impact of the MUM project, read here

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