In a quiet room at Mukono Health Centre IV in Uganda, Charity Kamahoro dozes peacefully, having just given birth to her first baby, a healthy girl named Justin, who is malaria-free because her mother took precautions and adhered to treatment during pregnancy.
When Nursing Officer Norah Nakimuli covers her with a kanga and asks how she is, the new mother smiles.
“It was an easy delivery,” the 18-year-old married homemaker says of the birth. “I had my first labor pains three days ago and came to the clinic last night.”
Nakimuli hands the baby to her and helps the new pair to breastfeed. Soon, Kamahoro will be discharged from the hospital and go home with the knowledge and supplies to keep herself and her baby healthy, most notably, malaria-free. Uganda ranks eighth in number of malaria infections in sub-Saharan Africa, with some of the highest reported malaria transmission rates in the world and perennial malaria transmission in 95.9 percent of the country.
Jhpiego is working in this region to build the capacity of health care providers like Nurse Nakimuli to prevent and treat malaria, emphasizing the importance of documenting patients’ adherence to a full course of intermittent preventive treatment of malaria in pregnancy, monitoring malaria commodities and distributing long-lasting insecticide-treated nets (LLINs) during antenatal care (ANC) visits.
She’s among 6,000 providers across 1,540 health facilities whose daily activities are directly impacted by the U.S. Agency for International Development’s (USAID) Malaria Action Program for Districts (MAPD), the aim of which is improving health outcomes for women and their families. The program—which provides technical and programmatic support to the Government of Uganda to increase the impact and reach of malaria prevention and diagnostic services, and to strengthen the government’s capacity to design, plan and monitor malaria control activities—features facility-based learning focused on mentorship and practice. Studies show that when providers like Nakimuli have short, repeated and frequent exposure to training in the context of real-life scenarios, they effectively acquire new skills and retain lessons. [MY1]
Delivery of preventive interventions as well as diagnosis and treatment services for malaria should be maintained provided that best practices for protecting health providers – and other front-line workers – from COVID-19 are followed.
— Dr. Gladys Tetteh, Director, Malaria, Jhpiego
Nakimuli learned how to help her patients and to help health care colleagues provide better care for their patients.
“As a malaria key influencer in this region, I feel more empowered to conduct malaria in pregnancy dialogues with other nurses in this health center after the mentorship workshop,” says Nakimuli.
Led by the Malaria Consortium and funded by the U.S. President’s Malaria Initiative, the program aims to reach more than 13 million people—37 percent of Uganda’s population—across 52 districts, over five years (2016-2021).
Dr. Thomson Ngabirano, the MAPD Malaria in Pregnancy Specialist, reported that over the past three years, 84 percent of all pregnant women have received bed nets and 61 percent have received three or more doses of sulphadoxine-pyrimethamine, commonly known as Fansidar, for malaria prevention in the districts supported by the program.
“The project interventions have helped to improve the quality of
ANC services in the supported districts,” he says, adding, “the aim is a healthy baby and healthy mother after delivery, no life is lost!”
More than 200 women visit the Mukono Health Center daily, providing Nakimuli ample opportunity to educate them and the community at large about malaria, pregnancy, newborn health and family planning. Among her fundamental messages: Giving birth in a health facility with the help of a skilled attendant helps to ensure healthy and safe deliveries.
“I first heard about the clinic six months ago from another mother who comes here,” Kamahoro says. “At that time, I knew I was pregnant, so I decided to come to the clinic to get good treatment for my baby. I did not know much about pregnancy and giving birth before I came here, but I was told to come once a month for treatment.”
Kamahoro did as she was advised, faithfully visiting the health center’s antenatal clinic every month. There, a midwife helped her to develop a birth preparedness plan and sent her home with an LLIN for protection from malaria. She learned that she should get treatment right away if she develops a fever, and had lessons in nutrition, hygiene and HIV. She was also advised to deliver in a hospital.
Starting in her second trimester, Kamahoro was given four doses of antimalarial tablets that she was instructed to take to protect herself and her baby.
Kamahoro’s ANC and hospital delivery have paid off: She had no complications during birth and Justin is healthy, weighing just over 8 lbs. Husband Mathias Odoi, 24, carries a bag packed with supplies, including contraceptives. The young family lives in Nabuti village in Mukono District, a 10-minute boda-boda (motorcycle taxi) ride from the health center located about 20 kilometers east of Kampala, Uganda’s capital city.
“The facilities here are very good, and the staff are nice,” Kamahoro says, adding that while she intends to tell her pregnant friends to come here, she herself doesn’t intend to get pregnant again any time soon.
For now, Kamahoro’s dreams are all about Justin: “I hope she will become a doctor, because the staff here have helped me.”
Learn more from the WHO about what is known about the novel coronavirus, how it spreads and how it is affecting malaria responses worldwide.
Kullein Ankunda is the Communications, External Relations and Knowledge Management officer for Jhpiego, Uganda.
