- No Woman Left Behind” Maternal health is human rights project: The roject contributed to reduction of maternal mortality in Magwi County South Sudan targeting vulnerable and marginalized women whose human and maternal health rights are at risk of violation. The project targeted two payams in Magwi County (Obbo and Magwi payam). Magwi County is located in Eastern Equatoria a state in the South East of South Sudan The project was implemented by IHO for a period of 12 months, between October 2014 and September 2015 funded by Open Society Initiative for Eastern Africa. The project Long term goal was to reduce maternal and neonatal morbidity among target communities and the short term goal of the project was to significantly generate evidence and increase the level of awareness and efforts promoting human and maternal health rights by involving all actors at different level.The project objectives were:
- To empower communities with rights-based approach to address the underlying causes of maternal mortality,
- To train traditional birth attendants and community leaders on best practices on home-based delivery and the rights based approach,
- To document experiences of women during pregnancy, delivery and after birth both at home and health facilities,
- To use the health cluster networks as a platform to push and demand for policy change and improved service delivery for maternal health using the rights-based approach.
The project activities performed within this period included; 47 TBAs trained on human and maternal health rights, 10 public meeting, 3 community leader meeting and 6 radio talks, production and distribution of IEC materials each promoting maternal health rights (4 banners, 80 t-shirts and 350 posters), attended 6 health/NGO forum meetings and presented maternal health issues and finally documentation of maternal death stories in Magwi County.
Key project Achievements
- The maternal health rights project reached marginalized and most deprived women in the community (illiterate and impoverished women and girls).The project public meetings targeted rural areas. Women and young girls were mobilized and educated on their maternal health and human rights and as a result, health facilities in Obbo and Magwi Payam recorded increased numbers on antenatal care attendance and delivery with tremendous reduction in maternal mortality. “Compared to the days before IHO started this project and now we have seen a tremendous increase in the number of mothers that attend antenatal care and deliver at our health facilities in Obbo and Magwi” reported Mr. Robert Labal Magwi County health officer.
- In the same regard, all in charges from Obbo PHCC, Magwi PHCC and Magwi DOT PHCC express a tremendous increase in mothers attending antenatal and delivering at the health facility. During the interaction, when the In-charges were asked what could be the factors contributing the increase in the numbers, Mr. Ssentongo David In-charge Magwi DOT and Mr. Oculi Tonny In-charge Obbo PHCC said, “First the increase can be attributed to awareness IHO has been doing and secondly, improved service delivery. However, despite the statement that the increase is due to improved service, this cannot be justified as more than 80% of maternal service users in the same facilities report not to receive quality maternal health services in the study carried IHO in June 2015. Mr. Otim Lwarence In-charge Magwi PHCC in the same manner attributed to the increase in antenatal attendance and increase deliver to the health rights awareness conducted by IHO and TBAs IHO trained who have improved the referral from the remote villages.
- The project brought together TBAs in Magwi County to work for a common goal of reducing neonatal and maternal mortality as a result this resulted to formation of an association named, “traditional birth attendant mama center.” This was the first project in the county of this kind to target TBAs in the County. This has created a visibility the TBA not only by becoming active in the intervention area by also the County administration. The TBA association is the first of this kind in south Sudan. The TBA trained by IHO reached more than 500 households through door to door approach (Educating women and other household members on maternal health rights). This has resulted to increase numbers in antenatal attendance and deliver in the health facility. Hence in the past three month no maternal deathhas been report in Magwi and OBBO Payam both in the community and the health facility.
- The project was not only welcomed by County Health Department, the commissioner and Community of Magwi County but it has empowered the community to take up a role in demanding better maternal health services in the County. The Community members have formed committees, developed action plan to improve maternal health services in the County bringing together Women, Men Girls and Boys to discuss and plan for maternal health services in the County as well as share experiences on maternal health rights violation.
- The project addressed cultural and traditional issues such as home deliveries were many members believed that there was no need of mothers attending antenatal care or delivery from health facility by a skilled birth attendant as traditionally women delivered at home successfully. The projected clarified to members that delivering at health facility was not about destroying the community culture but for the wellbeing of women and children as this is their human and health rights granted by the constitution and other international instruments.
- Building Community Capacity for Improve delivery of Maternal Health Services project: This project is funded by OSIEA for the following period:December 2015- September 2017 implemented inMagwi County in the Eastern Equatorial of the County. The project Long term goal is to reduce maternal and neonatal mortality in Magwi County and the short term goal is to ensure marginalized poor rural women in Magwi County access quality maternal health services. The project objectives are:
- Increase public participation in health planning, financing and governance by strengthening community-based initiatives that empowers community members to know and demand their rights and entitlements in health.
- Strengthen the capacity of health workers, the Rights Based Approach to maternal health care services
- Increase the capacity of decision-makers at local, county and state levels for policy commitments, evidence-based planning and resource allocation.
To achieve the above goals and objectives, IHO has to train health facility management committees on the need, purpose and application/operationalization of the score card as an important monitoring tool for quality health services provision, conducted quarterly meetings with Home health promoters/TBAs to share stories and experiences in promoting maternal rights and well as carry out documentation, organized community level meetings to develop score cards with indicators for evaluation supporting health duty bearers’ self-assessment as per the voices of community using indicators developed by community members, organize interface/dialogue meetings between health services providers and community to ensure feedback from the community, arrange a radio talk show between health activists and health duty bearers, develop and distribute IEC materials promoting maternal health rights, work with National Ministry of Health to adopt a patients charter and training manual for health workers on rights based approach, orient health workers on the principals and approaches to deliver human rights
based health services, conduct health workers self-assessment meeting to develop score cards with indicators for evaluation supporting health service delivery, conducted project inception meetings with the state and county officials, work with national Ministry of Health to adopt a patients charter in south Sudan, train Boma Health management committees (BHMCs) on use of scorecard and conduct monthly facility monitoring, gather evidence data through the CSC process shared and conduct dialogue/feedback/follow up meeting with members of parliament Magwi County, Payam, County, and state health department and share information and documentation) of the issues, gaps and solutions identified in the analysis and asking them to take specific actions to show their commitment to improved maternal health services
- Creating a Line for Family Planning in the Ministry of Health State Budget project: The Population Action International (PAI) funded project aimed at ensuring that Imatong state Eastern Equatoria allocates 1.5 million SSP for family planning in the MOH budget for FY2016/17 by August 2016 through creation of a FP budget line item in the state health budget. The projected is implemented by impact health organization (IHO) in Imatong state formerly Eastern Equatoria State South Sudan from April 2016 to January 2017. The project targets key decision makers such as the, State Minister of Finance, State Minister of Health, Speaker State Legislative Assembly as well as other influential people in the state.