Mother-child health in Lacor-South Sudan (IMCHA)
Programs and partnerships
Lead institution(s)
Summary
Implementing comprehensive, community-focused primary health care is a major challenge in post-conflict regions such as South Sudan and neighbouring Northern Uganda. South Sudan is recovering from two decades of civil war that have destroyed education and health infrastructure.Read more
Implementing comprehensive, community-focused primary health care is a major challenge in post-conflict regions such as South Sudan and neighbouring Northern Uganda. South Sudan is recovering from two decades of civil war that have destroyed education and health infrastructure. Torit Hospital, one of the major hospitals in the region, is poorly staffed and lacks specialists and basic equipment. The situation is similar in Northern Uganda. In the District of Gulu, the burden of disease has largely been managed through St. Mary's Hospital Lacor. This region has not been able to achieve the progress in maternal and child health that has been reached in the central part of Uganda.
This project assesses the implementation and scale of community-focused reproductive and child health interventions in post-conflict settings. It focuses on establishing evidence to promote sustainability and resilience, with the goal of ensuring access to essential health services by vulnerable populations. The researchers will explore strategies for improved maternal care and child nutrition services, cervical cancer screening, and support for women's empowerment through outreach efforts from the two hospitals.
Research findings will be validated through ministries of health at the local, district, and national levels to optimize engagement and to encourage adoption of the project's recommendations to strengthen systems. The results of the study will directly inform the ministries of health in South Sudan and in Uganda on related interventions, including a scalable model for improved community-based services. This will address barriers to interventions, reduce maternal and child mortality, and extend the reach of health services to communities that have faced shocks and stressors.
This is part of the Innovating for Maternal and Child Health in Africa (IMCHA) initiative, a seven year, $CA36 million multi-donor partnership funded by Global Affairs Canada, the Canadian Institutes of Health Research, and Canada's International Development Research Centre.
Objectives /
Research outputs
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Women, men, and youth have clear understandings of the benefits of adequate child spacing. As women are disempowered to exercise child spacing, this knowledge is difficult to translate into practice. Women who use contraceptives without their husbands’ consent risk losing financial and social assets and are likely to be subject to intra-partner violence including forced intercourse. This detailed paper explores women’s experiences and community views on short birth intervals, to inform and promote culturally safe child spacing in Northern Uganda. A shorter breastfeeding period and the female gender of the previous child have been factors consistently associated with short birth intervals.
Conflict-affected settings impact the implementation of effective reproductive, maternal, newborn, child, and adolescent health (RMNCAH) programs and policies. Pregnant women, neonates, children, and adolescents are at higher risk of dying in fragile and conflict-affected settings. The article provides health policy background and context details charting RMNCAH data. South Sudan remains one of the most volatile states in the world. Ministry of Health (MoH) leadership along with enhanced governance and accountability mechanisms are key determinants for strengthened health systems. Due to the instability of the country and multiple international partner dynamics, the policy context changes quickly.
The study reviews original primary research that examined relationships between equity-focused legislation and policy, and the utilisation of sexual and reproductive health (SRH) services by vulnerable populations in sub-Saharan Africa. Findings show that health-related legislation and policy promoted an increase in service utilisation, over time, especially for antenatal care, skilled birth attendance and facility-based delivery. However, social health inequalities persist among subgroups of women. Neither the reviewed studies or policies specifically addressed youth, people living with HIV and people with disabilities. Compared to other regions worldwide, sub-Saharan Africa had the highest average maternal mortality ratio (2017) and HIV prevalence (2018).
Kangaroo mother care (KMC) has been identified as an alternative way to care for low-birthweight (LBW) and preterm neonates. It promotes parent-child bonding and breastfeeding, and stabilizes the vital signs of the neonate, particularly body temperature and heart and respiratory rates, leading to increased weight gain and improved growth. KMC reduces the need for expensive conventional medical care, improves parental involvement in care provision and offers opportunities for health education. The article proposes a systematic review of the literature to identify barriers and to facilitate uptake of KMC.
Community-based women’s groups using a participatory learning and action (PLA) cycle are effective in promoting maternal and child health. The PLA women’s group intervention encouraged health promotion activities and community mobilization in Gulu district, Uganda (2017). This area has a high burden of unmet needs in family planning, neonatal mortality, teenage pregnancy, and child mortality. The women’s group enabled participants to adopt behaviours to protect their health and their children’s health at individual and community levels. Women extended their agency to control financial resources and developed strategies to stop domestic violence. As a result, there was a reduction in mistreatment of children.
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