In Uganda, 6,000 mothers¹ and 45,000² newborns die every year due to lack of access to skilled attendants at birth. Throughout the world women are dying needlessly from common complications of pregnancy and labor that can easily be treated by those who possess the knowledge and skills, and in health facilities that are prepared for such emergencies. The vast majority of these deaths (94%) occur in low-resource settings, and most could have been prevented by addressing each of these 3 delays³:
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The delay in the decision to seek skilled maternity and newborn care
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The delay in accessing skilled maternity and newborn care once the decision is made
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The delay to receive quality care once reaching a health facility
Since 2015, Brick by Brick Uganda’s Babies and Mothers Alive (BAMA) programme has been working in the Rakai and Kyotera Districts of Uganda, in 48 free government funded health facilities to improve the quality of maternal and newborn care. We have also engaged the broader community to increase awareness of the importance of institutional delivery. Now, thanks to the support of the Wehubit programme of Enabel, our BAMA programme will address the 2nd delay, providing life-saving transportation by linking rural women in labor to local motorcycle taxi drivers, using our innovative and simple mobile phone app. We will also link mothers in labor in need of emergency transfer to automobile taxis or ambulances. This is the Mama Rescue project.
Grace is a motorcycle driver who is committed to saving the lives of mothers (© BrickbyBrick)
Grace Nakintu is a 25-year-old woman from Kibaale Village, in Kyarurangira sub-county, Rakai District. Tragically Grace lost her baby in 2012 as she struggled to reach the hospital.
‘I was pregnant and developed complications, but because of difficulty in accessing means of transport to the hospital, my baby was tired and died on our way to the hospital. The doctors operated on me immediately after I reached the hospital. The doctors didn’t know that my baby was already dead.’ Grace narrates.
Mama Rescue is an innovative, simple mobile phone application/transport platform and emergency dispatch system improving access to quality and safe obstetric services to mothers in rural communities. It provides transport for mothers in labor from home to the health center where they can deliver with a skilled midwife and emergency transport from the health center to the hospital where women can receive urgent obstetric care in the event of a complication. Mothers who have attended all four antenatal visits are given a transport voucher with an individualized number. Once in labor they simply give this number to the trained Mama Rescue driver in their village who transports her to the nearest health center. The driver is immediately paid with mobile money upon completing the journey.
‘17-years-old, I was curled into a fetal position and wept to reach help. Sometimes I would stop, bend and put my hand on my thigh to support my body, to rest a bit,” Grace says. My family had no idea who to call as I writhed in pain. My husband Umaru Kabiito begged drivers to take me to the health center that is a mile away, and no one was willing to help.’ Says Grace.
The Mama Rescue project aims to increase the percentage of births that take place in health facilities and improve timely referral for women with complications in labor and the immediate postpartum period.
A driver from the Mama Rescue project arrived at the maternity ward with a pregnant woman (© BrickbyBrick)
‘My experience of losing my baby pushed me to start riding a boda boda (motorcycle taxi) so that I can support my fellow women who are pregnant to reach the hospital on time and not have complications leading to the death of their babies. Several mothers call me at any time from the neighboring villages to come and take them to the hospital to save both the life of the mother and the baby.’
In the month of November Mama Rescue will be launched to serve over 10,000 women annually in need of emergency transport. Grace will join the over 100 boda boda drivers in helping us to save the lives of mothers and babies in Uganda.
‘I wish to thank the BAMA programme and Enabel that is helping them to implement the Mama Rescue project for allowing me to be one of the first Mama Rescue drivers to help my fellow women to reach the health centres so that they don’t go through what I went through. Thank you very much.’
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¹ https://www.who.int/gho/maternal_health/countries/uga.pdf?ua=1
² https://www.unicef.org/uganda/what-we-do/rmncah
³ Trends in maternal mortality: 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: World Health Organization; 2019