Thursday, March 5, 2015

It all started with one village...

By Devin Faris
S.O.U.L. Foundation Global Health Corps Fellow

It all started with one village.

When we arrived in Bujagali as S.O.U.L.’s new Global Health Corps (GHC) Fellows, we were welcomed with open arms and open hearts for the important work we were about to embark upon. S.O.U.L.’s vision for a new partnership with GHC was to engage the village in in-depth discussions about the maternal health needs of the community in an effort to inform future programming through S.O.U.L.’s Maternal Health Network. We arrived with the humility to recognize that we lacked the knowledge required to properly inform such a program.

So, we started by doing what S.O.U.L. does best: we listened.

We listened to local women leaders like Maama Ali and Maama Muganda about the lives and needs of women in this corner of Uganda. We listened to trusted midwives like Lillian and Rose working in government health centers, as well as traditional midwives like Celementina delivering from their homes, about what it is really like to respond to these needs with the limited resources available to them. We listened to government officials in Jinja about how much power they have to enable these maternal health services to exist within an overburdened and under resourced health system.

The more we listened, the more we learned that listening to just one village was not enough. Nearly 2/3 of women in Bujagali deliver their newborns with Celementina, but what about elsewhere in the Jinja District where Celementina is not the nearest birthing option? What role does proximity to a health center play in maternal health decision-making? What role do health officials play in addressing challenges to access, and what barriers do male partners create for women in seeking appropriate care? In order for S.O.U.L. to truly make an impact, we realized we needed to think bigger.

With clearance from TASO Uganda’s Institutional Review Committee and the Office of the President for our research, we worked with local women, midwives, and health workers to design a comprehensive needs assessment that incorporated the viewpoints of women, husbands, health workers, traditional midwives, health officials, and Village Health Teams through a series of interview and focus group questionnaires. We trained three young and passionate enumerators to help us collect our data and expanded the scope of the research from one village to 11 villages across the Kiira Health Sub-District, comprised of Budondo and Butagaya Sub-Counties. With data from the whole health sub-district, S.O.U.L. will not only have representative information to inform our own programming, but we will have data that has never been collected before in rural Jinja. Since health statistics in Uganda come from health center reports, our data will account for the thousands of women who do not regularly visit health centers and are consequently not included in the formulation of district health priorities. With this data, we will be able to advocate for the needs of women whose voices have never been heard.

S.O.U.L. is firmly dedicated to making all of its programming sustainable, scalable, and replicable. This approach would not be possible without investing the time to truly listen and learn what the women of our community need. In our first six months here in Uganda, we have already learned from these women that while S.O.U.L. is “supporting opportunities for Ugandans to learn,” it is really these Ugandans who are allowing us to learn more than we thought we could. Each and every one of these women has a unique story to tell. Each has their unique struggles, their unique triumphs, and their unique voice. At S.O.U.L., it is our job to ensure the voices of these women are amplified. These are the women whose stories we wish to tell over the coming months as our Maternal Health Network takes flight, as they are the women whose resilience, compassion and wisdom inspire us to do the very work we do here in Uganda.