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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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.
The study works to better understand and document how people with disabilities perceive the relationships between their use of sexual and reproductive health (SHR) services, legislation and health policy in three Northern districts of post-conflict Uganda (Gulu, Amuru, Omoro). Findings from interview participants reveal that disabled people’s access to SHR services is shaped by intersections of gender, disability, and violence. They experience discrimination across both private-for-profit and public health facilities. The voices of participants reflected in this article add clarity to the findings. The 2030 Sustainable Development Goals committed to “Leave No One Behind” regardless of social identity.
Emerging from 20 years of armed conflict, Uganda adopted laws and policies to protect the rights of people with disabilities, including sexual and reproductive health (SRH) rights. This study reflects on the difficulty of implementing disability-focused policy in Uganda. One fifth of the country’s population was estimated to live with some disability (2008). Armed conflict between the Government and the Lord’s Resistance Army caused breakdowns in social systems, and generated widespread trauma for Northern Ugandans. An intersectionality-informed analysis enables policy makers and researchers to examine intersecting social identities and diverse sources of knowledge that can contribute to improved policy solutions.
Participatory service improvement is feasible and acceptable in post-conflict settings like Northern Uganda. The study engaged stakeholder participants who identified obstructions to accessing perinatal care: lack of savings for childbirth costs in facility-based delivery, lack of male partner support, and poor service provider attitudes. The civil war in Northern Uganda (1986– 2006) displaced more than 90% of the population of that region. Northern Uganda has among the highest global maternal mortality rates (610 per 100,000 live births). Engaging communities in identifying perinatal service delivery issues can generate community-led solutions and increases trust between community members and service providers.
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