In areas of Uganda over 5km from the nearest health facility, pregnant women rarely receive the recommended four pre-natal visits to see a midwife, many women are unable to deliver in a health facility, and young babies are rarely taken to get early life checkups and vaccines -- yet services are available for free at health facilities. This gap leads to higher infant and mother mortality and morbidity because the mother and child do not get adequate care and information. We want to break down these barriers to accessing care by bringing midwives and other health workers to remote villages on a monthly basis so that they can give treatment and information to children and expectant mothers, as well as giving them access to emergency medical transportation to reach a health facility.
To do this we shall implement monthly one-day comprehensive health clinics and motorcycle ambulance trailers in remote villages in Uganda. There are four parts to the solution:
1) TRANSPORTATION & MICROFINANCE
First, we engage with the local health facility to choose which villages to target. If the health workers do not have access to transportation, we microfinance a motorcycle or boat taxi to a local resident searching for economic opportunity. The person who takes out the loan runs his own motorcycle or boat taxi business and, as a condition of the loan, serves 3 nearby villages with monthly one-day clinics. On those days that he serves the villages, he is only compensated for fuel. Thus, the taxi driver runs his business for 27 days in a month and must be available for clinics three days that month.
2) MONTHLY ONE-DAY CLINICS
We establish a system to conduct monthly, one-day comprehensive health clinics in remote villages. Three-to-four government health workers (including at least one midwife) and their equipment are transported to villages so they can provide free services, including prenatal checkups, vaccinations, postnatal checkups, birth information, family planning, anti-retroviral treatment, malaria treatment, HIV tests, child checkups, and other life-saving services. Health workers return to served villages once per month to assure continuity of care.
3) COMMUNITY PARTNERSHIPS
We partner with community groups to oversee the project, so that it is eventually successfully transitioned to the community. Community groups collect $0.55 (UGX 2,000) from each patient to pay fuel costs and health worker stipends. This small amount is able to pay the travel expenses ($20-26, UGX 71,000-91,000) of a one-day clinic. Otherwise, services are provided free of charge. Over time, there is less need for an outside organization to oversee the clinic activities.
4) MOTORCYCLE AMBULANCE TRAILERS
In order to provide affordable emergency transportation for deliveries and other needs, motorcycle ambulance trailers will be available at health facilities. When a patient needs transportation, they can request a motorcycle taxi driver to pick up the trailer and then carry them to the nearest health facility. Motorcycle ambulance trailers are manufactured in Uganda by Pulse Uganda http://pulse.ug
The program not only helps to bring healthcare to mothers, children, and others living in remote areas, but also improving the local economy, helping individuals earn a living and become self-reliant. The program is designed to help local communities take ownership of their health and wellness by transitioning these programs to the villages after time.