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Immunize to Thrive: Empowering Teen Moms and their Babies

Empower teen moms to vaccinate their children through increasing demand by expanding knowledge about healthy immunization strategies.

Photo of Courtney Tucker
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Describe what you intend to do and how you'll do it in one sentence (required 250 Characters)

Utilize community health networks to educate teen moms and caregivers in rural Uganda by dispelling myths and expanding evidence-based knowledge of healthy immunization strategies to increase the demand for vital vaccinations for children under 5.

Explain the idea (less than 2,000 characters)

One of the main factors that influences the realization of full childhood immunization is maternal education. In the community of Luwero where Shanti Uganda serves women and adolescents of childbearing age, maternal education is low, particularly amongst the 15-19 year age group. 14% of girls ages 10-19 have given birth to one child and 50% of young women in the community are married before 18. As a result, young women are often forced to drop out of school and stay home with their children which forces them to miss out on vital reproductive health education and face stigmatization when accessing reproductive and sexual health services. Challenges persist in the postpartum period because young caregivers do not have access to knowledge about infant care. Evidence shows that the intent of the mother to vaccinate their child is the leading determinant for accessing the three doses of critical infant vaccines. By targeting young women in rural Uganda who lack appropriate knowledge around such issues, this project will increase the demand for vaccinations by expanding knowledge about the importance and effectiveness of timely immunization practices. These educational activities will lead to an increase in immunized infants which will have the long-term impact of reducing child mortality from vaccine-preventable diseases so children may thrive and contribute to a stronger, more productive community. Please see attached visual for a description of project activities.

Which part(s) of the world does this idea target?

  • Eastern Africa

Geographic Focus (less than 250 Characters)

Luwero District is in central Uganda and has a population of more than 450,000. The majority of the population engages in subsistence agriculture and much of the district is still considered rural.

Who are your end users and how well do you know them? (750 characters)

In 2018, 18% of our beneficiaries were in the 15-19 age bracket and accessed our postnatal care, including vaccinations. The Propelling Motherhood project, which involved 20 CHEWs make 496 postnatal home visits, enabled Shanti to strengthen and expand contact with rural communities throughout Luwero. From these past and current interactions, we have witnessed a strong desire for young caregivers to take ownership and learn about infant care, specifically in immunization practices.

How is the idea unique? (750 Characters)

Currently, the Uganda National Expanded Programme on Immunization targets women of childbearing age from 15-45. However, teen moms experience the most stigma when accessing healthcare facilities for themselves and their children. First, we will deliver knowledge and services to teen moms at the household level, thereby eliminating stigma and geographic barriers to access. Second, CHEWs will combine trusted, traditional networks with modern, evidence-based healthcare practices, to provide individualized education about healthy immunization practices to teen moms. By working within traditional networks, teen moms will receive culturally-appropriate information that will reduce stigma and improve infant health outcomes.

Idea Proposal Stage (Select 1)

  • Pilot: We have started to implement the idea as a whole with a first set of real users. The feasibility of an innovation is tested in a small-scale and real world application (i.e. 3-15% of the target population)

How many months are required for the project idea? (140 characters)

It will take 18 months to plan, implement, and evaluate the pilot project to increase knowledge and uptake in vaccination usage.

Organization Name (less than 140 characters)

The Shanti Birth House operated by Budondo Intercultural Center

Type of Submitter

  • We are a Cooperative or Community-Owned Organization

Organizational Characteristics

  • Female-led organization
  • Women’s health/rights focused
  • Locally/community-led organization

Organization Location (less than 140 Characters)

We are located in Nsasi Village, Luwero District, Central Uganda.

What is the current scale of your organization’s work?

  • Community (working within one or a few local communities within a region)

Website URL

https://shantiuganda.org/

Tell us more about your organization/company (1-2 sentences)

The Shanti Birth House, operated by Budondo Intercultural Center, is focused on improving maternal and infant health in Uganda. As an organization, we are focused on ensuring rural communities live healthy, productive lives. By implementing a vaccination outreach program, we would be strengthening our Postpartum Home Visit Program which aims to expand the utilization of Respectful Midwifery Care and post-natal services by pregnant women and new mothers.

Who will work alongside your organization in the project idea? (750 characters)

We will continue to work closely with the Luwero District Health Office, the local arm of the Ugandan Ministry of Health, to augment national efforts to increase knowledge and ultimately, vaccination uptake. We will also seek advice from organizations such as GAVI and MACIS who are targeting the supply side by increasing coverage and reducing barriers to immunization access. Equipped with up-to-date knowledge about the supply side, we will ensure that teen moms have relevant and accurate info about their rights to coverage and access when demanding vaccinations. We have strong working relationships with partners like Population Services International who provide family planning commodities and capacity development to Shanti Uganda midwives.

How many people are on your team?

16

Tell us more about you and your team

The Shanti Birth House team is prepared to intervene at this critical point because we are viewed as a strong pillar in the healthcare community that honors the desires of the community while imparting evidence-based knowledge and services. The team will include The Head Midwife, three additional midwife, 10 CHEWs, the Program Manager and Country Director. Head Midwife, Sister Josephine Kizito, will advise project staff, facilitate trainings and oversee performance. 3 additional midwives: Nakkubwa Rachael, Sister Lule Florence, and Mukisa Winnie. 9 Community Health Extension Workers will be led by one Leader, Nagawa Florence, who will be the primary contact between the Head Midwife and the other project staff. Program Manager, Tendo Edith, and Country Director, Courtney Tucker, will supervise and evaluate the project.

Overview of How Your Concept Has Evolved (5-6 sentences):

One of the biggest learnings was around the actual needs and desires of the teen moms themselves. We learned that stereotyping and stigmatization play huge roles in the utilization of health services; as such, we will definitely incorporate respectful, inclusive curriculum into our activities. Additionally, we have learned about other important community activities that are already taking place in the immunization space, and we are excited to incorporate them into this activity as well, while still focusing on teen moms. Finally, the Business Model really helped us narrow down the exact cost categories both so we can budget well and so that we can heavily utilize existing structures to promote sustainability and affordability.

Viability (3-4 sentences and activity upload):

https://canvanizer.com/canvas/reHsOlqfGpDev During the 18 month project cycle, we will follow a proven project implementation and monitoring plan. First, we will meet with key project contributors, including the DHO, project staff and contractors, and community stakeholders. Second, we will begin mobilising new VHT contractors. Then, after creating appropriate timelines, geographical strategies and general project procedures, we will mobilise teen moms as participants and activities will commence. Throughout the implementation period, thorough montioring, evaluation, and learning will take place and key takeaways and learnings will be implemented and reported on to all project stakeholders.

Feasibility (3-4 sentences):

The Shanti Uganda Birth House has been active in the local community healthcare ecosystem for more than 8 years. As such, we are viewed as a safe, respectable place to receive maternal and infant education and health care. We will use this trusted foundation to encourage vulnerable clients to access and receive services. We provide high-quality health care which equips mothers will the evidence-based knowledge they need to make healthy decisions for their families. To date, 1,701 babies have been born at the Birth House and more than 13,000 have received immunizations.

Desirability (3-4 sentences and activity upload):

We tackled this question in two ways: thinking about our past experience with service delivery and education to teen girls groups and also talking with current teen moms who come to the Birth House for education. Two key points they came up consistently were the issues of accessibility of services and knowledge gaps. We tried to design a user experience that touched on both of these points in ways that were respectful and met clients in their unique situations. Our clients will be visited in their homes, if so desired, and will be given access to immunizations and information in a respectful, holistic manner that encourages them to join the healthcare ecosystem as lifelong customers.

Community Focus (2-3 sentences):

In our experience doing sexual and reproductive health workshops for teen girls in our area, we quickly learned that young women who get pregnant face uniquely difficult challenges. They are usually forced to drop out of school and face extreme stigmatization. As such, they miss out on vital maternal health information and as a result, their children face challenges such as malnutrition and illness due to preventable illnesses. Roughly 14% of girls have given birth by the age of 19 but lack this critical information. We witness the deadly impacts of these knowledge gaps on a daily basis.

Community Impact (2-3 sentences):

Primary differences: increased vaccine uptake by babies born to teen moms and increased immunization knowledge held by teen moms. Because most immunizations take place in the first nine months of life, it will take the first nine months of the project to see results. Project sustainability beyond this support will be maintained by DHO and community collaboration. By including key healthcare leaders and community members, we will ensure that our neighbors are the ones who own and promote this project far beyond this particular funding cycle.

2 comments

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Photo of Ashley Tillman
Team

Hi Courtney Tucker great to have you in the Challenge! Can you share a few more details about how your pilot is going to date, i.e. what what, what were learnings and insights to improve? Would also love to hear a bit more about how you currently work with Luwero District Health Office?

Photo of Courtney Tucker
Team

Hi Ashley. Thanks for the questions!

To date, our pilot is going fairly well, but one of the biggest learnings we've had so far is that multiple actors and societal forces exert their unique influences on the lives and decision-making strategies of young mothers. Targeting one single factor is not enough. Instead, we have witnessed the value in meeting girls where they are individually and addressing unique concerns for each mother. For example, the lived experiences of girls who give birth and go back to school are very different than those that are forced to drop out of school permanently. As such, we must not only target the adolescent mothers themselves but contact caretakers, neighbors, peers, religious and school leaders, etc. to really get to the heart of the forces that influence their decisions around healthcare and motherhood.

We have worked closely with the District Health Office in Luwero for more than 10 years now. They offer a variety of support mechanisms including our data collection tools, capacity building for our health workers and administrators, important linkages to government and nongovernment actors, and distribution of vaccination supplies. We work hand-in-hand to share knowledge and ensure we're augmenting local and national efforts.