{"page":"\u003clink rel=\"stylesheet\" href=\"https://lessonplanet.com/assets/packs/css/resources-572d6a42.css\" /\u003e\n\u003clink rel=\"stylesheet\" href=\"https://lessonplanet.com/assets/packs/css/lp_boclips_stylesheets-f4d0de30.css\" media=\"all\" /\u003e\n\u003cdiv data-title='Mothers encouraged to attend medical clinics' data-url='/boclips/videos/5c54bea4d8eafeecae13d36c' data-video-url='/boclips/videos/5c54bea4d8eafeecae13d36c' id='bo_player_modal'\u003e\n\u003cdiv class='boclips-resource-page modal-dialog panel-container'\u003e\n\u003cdiv class='react-notifications-root'\u003e\u003c/div\u003e\n\u003cdiv class='rp-header'\u003e\n\u003cdiv class='rp-type'\u003e\n\u003ci aria-hidden='true' class='fai fa-regular fa-circle-play'\u003e\u003c/i\u003e\nVideo\n\u003c/div\u003e\n\u003ch1 class='rp-title' id='video-title'\u003e\nMothers encouraged to attend medical clinics\n\u003c/h1\u003e\n\u003cdiv class='rp-actions'\u003e\n\u003cdiv class='mr-1'\u003e\n\u003ca class=\"btn btn-success\" data-posthog-event=\"Signup: LP Signup Activity\" data-posthog-location=\"body_link_boclips\" data-remote=\"true\" href=\"/subscription/new\"\u003e\u003cspan\u003e\u003cspan\u003eGet Free Access\u003c/span\u003e\u003cspan class=\"\"\u003e for 10 Days\u003c/span\u003e\u003cspan\u003e!\u003c/span\u003e\u003c/span\u003e\u003c/a\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class='rp-body'\u003e\n\u003cdiv class='rp-info'\u003e\n\u003cdiv aria-label='Hide resource details' class='rp-hide-info' role='button' tabindex='0'\u003e\u0026times;\u003c/div\u003e\n\u003ci aria-label='Expand resource details' class='rp-expand-info fai fa-solid fa-up-right-and-down-left-from-center' role='button' tabindex='0'\u003e\u003c/i\u003e\n\u003ci aria-label='Compress resource details' class='rp-compress-info fai fa-solid fa-down-left-and-up-right-to-center' role='button' tabindex='0'\u003e\u003c/i\u003e\n\u003cdiv class='rp-rating'\u003e\n\u003cspan class='resource-pool'\u003e\n\u003cspan class='pool-label'\u003ePublisher:\u003c/span\u003e\n\u003cspan class='pool-name'\u003e\n\u003cspan class='text'\u003e\u003ca data-publisher-id=\"30356011\" href=\"/search?publisher_ids%5B%5D=30356011\"\u003eCurated Video\u003c/a\u003e\u003c/span\u003e\n\u003c/span\u003e\n\u003c/span\u003e\n\u003c/div\u003e\n\u003cdiv class='rp-description'\u003e\n\u003cspan class='short-description'\u003eMbarara District - April 23, 2009 1. Pan from baby to Midwife with stethoscope2. Mid of women patients at clinic3. Close of 18 year old mother Tumusimirwe Jadress pan to baby4. SOUNDBITE (Runyankole) between Tumusimirwe Jadress and Kathe...\u003c/span\u003e\n\u003cspan class='full-description hide'\u003eMbarara District - April 23, 2009 \u003cbr/\u003e1. Pan from baby to Midwife with stethoscope\u003cbr/\u003e2. Mid of women patients at clinic\u003cbr/\u003e3. Close of 18 year old mother Tumusimirwe Jadress pan to baby\u003cbr/\u003e4. SOUNDBITE (Runyankole) between Tumusimirwe Jadress and Kathe Medical clinic Midwife:\u003cbr/\u003e(MIDWIFE) \"How do you feel after the delivery?\"\u003cbr/\u003e(JADRESS) \"At first I had some pain but now I'm ok\"\u003cbr/\u003e(MIDWIFE) \"About the service you got, did you appreciate it?\"\u003cbr/\u003e(JADRESS) \"Yes I appreciated it\"\u003cbr/\u003e(MIDWIFE) \"Tell us what you appreciated about it\"\u003cbr/\u003e(JADRESS) \"What impressed me is that I bought the voucher and came to deliver from here.\"\u003cbr/\u003e(MIDEWIFE) \"How much did you buy it for?\"\u003cbr/\u003e(JADRESS) \"3000UgSh\" ($1.44 US)\u003cbr/\u003e5. Close of Tumusimirwe Jadress\u003cbr/\u003e6. Pan from doctor taking blood pressure to doctor's face. \u003cbr/\u003e7. SOUNDBITE (English) Dr Kamugisha Asaph, Senior Clinical Officer, Kathe Clinic. \u003cbr/\u003e\"Pregnant women with vouchers are given four antenatal visits, one delivery and one postnatal visit\"\u003cbr/\u003e8. Pan from road to Kathe Medical clinic\u003cbr/\u003e9. Pan from Marire Stopes OBA Van to Kathe Medical clinic sign\u003cbr/\u003e10. SOUNDBITE (English) Dr Kamugisha Asaph, Senior Clinical Officer, Kathe Clinic. \u003cbr/\u003e \"We were receiving an average of five women a day, but these days the number has increased, almost we can see 12 women in a day\"  \u003cbr/\u003e11.  Walking shot of a CBD (Community based distributor) Goretti Gavana walking to village to sell vouchers\u003cbr/\u003e12.  Close of pregnant woman. \u003cbr/\u003e13.  UPSOUND (Runyankole) Goretti Gavana,CBD (Community based distributor) speaking to pregnant woman.\u003cbr/\u003e\"I work with Marie Stopes and we care for pregnant women. We sell them vouchers to help them access help. When you have it, you can go to the doctor and be examined free of charge. He examines you up to four times. Even at the time of delivery, you go with only the stuff to deliver in, those to help the new born. Pads, the gloves, the plastic sheet to deliver on will all be there. There is even help just in case you fail to deliver and need referral for a caesarean.\"\u003cbr/\u003e14. CBD explaining to woman how the voucher works\u003cbr/\u003e15.  Woman buying the voucher\u003cbr/\u003e16.  Pan from road to Marie Stopes Mbarara district office and Headquarters for the OBA programme\u003cbr/\u003e17.  Set up of Christine Namayanja, OBA Project co-ordinator:\u003cbr/\u003e18. SOUNDBITE (English) Christine Namayanja, OBA Project co-ordinator:\u003cbr/\u003e\"We are seeing less mothers having complications during delivery we are seeing mothers who are more aware of their pregnancy the developments of their pregnancy, who are getting information on nutrition from the service providers and also how to care for their babies after delivery, so there are so many services attached to this voucher.\"\u003cbr/\u003e19. Close of baby\u003cbr/\u003e20. Close of baby voucher.\u003cbr/\u003e21. Wide of birth attendant entering her clinic pan to earth floor.\u003cbr/\u003e22. Bed where women give birth\u003cbr/\u003e23. SOUNDBITE (Runyankole) Alice Mugumya, Traditional Birth Attendant\u003cbr/\u003e\"I would use my hands to know whether the child is lying or seated, but there after I became educated when I was selected by the authorities in the sub county to get training. They selected me for training in midwifery for three months.\"\u003cbr/\u003e(TRANSLATOR) \"Who trained you?\"\u003cbr/\u003e(ALICE MUGUMYA) \"I studied at our health centre here in Buteraniro\"\u003cbr/\u003e24.  Wide of Alice Mugumya holding poster zoom in\u003cbr/\u003eUNICEF'S 2009 State of the World's Children report focus on maternal and neo natal health. \u003cbr/\u003eThe United Nations Children Fund UNICEF says that in Eastern and Southern Africa women face a 1 in 29 risk of maternal death compared to 1 in 8,000 in industrialised countries.\u003cbr/\u003eBut one programme in Uganda gives women access to medical care both before and after birth.\u003cbr/\u003eFour antenatal visits, a birth in a safe clean clinic and one postnatal check up... all for the price of a cup of coffee.\u003cbr/\u003ePregnant women in Uganda are now being offered the chance to deliver in a clean hospital with free ante natal and post natal check ups at a cost of only 3000UgSh (approx $1).\u003cbr/\u003eEighteen year old Tumusimirwe Jadress recently gave birth at a local clinic in Mbarara District.\u003cbr/\u003eMum and baby are doing well, partly in thanks to the quality of care they received. \u003cbr/\u003eWithout the vouchers  Jadress would have either had to pay over one month's salary to deliver in the Kathe Clinic, or most likely she would have delivered at home unaided, or with the help of relatives or traditional birth attendants.\u003cbr/\u003eBut now she can receive good quality advice and services by qualified doctors and midwives, greatly improving her chances of a safe delivery. \u003cbr/\u003eUNICEF'S 2009 State of the World's Children says that in Uganda, although there are declines in maternal mortality,a review of emergency obstetric care facilities showed that in 54 districts out of 56 throughout the country, over 97 per cent of facilities expected to provide basic emergency services were not able to do so. \u003cbr/\u003eLack of running water, electricity, and functioning operating theatres were among the key impediments to service delivery.\u003cbr/\u003eThe programme at the Kathe clinic in Mbarara District is managed by Marie Stopes International Uganda, an organisation that advocates quality reproductive health care, supported by the German Development Bank (KfW) and the Global Partnership on Output Based Aid of the World Bank.\u003cbr/\u003eDr Kamugisha Asaph, Senior Clinical Officer of the Kathe clinic, says the voucher scheme has resulted in an increase of the number expectant mothers attending his clinic from 5 to 12 women a week. \u003cbr/\u003eThe clinics are chosen by the Marie Stopes charity to ensure the highest quality of service available for its patients. \u003cbr/\u003eThe programme, labelled OBS (Output Based Service) reimburses clinics for services completed, rather than giving them money in advance. \u003cbr/\u003eThe clinics are only paid for the number of patients they have seen.\u003cbr/\u003eGoretti Gavana is a CBD (Community Based Distributor). \u003cbr/\u003eHer job involves meeting mothers in low-income areas to sell vouchers, explaining the benefits and discusses any queries they may have. \u003cbr/\u003eEach claimant is assessed to see whether she meets the poverty grading criteria which determines if she qualifies for the voucher scheme. \u003cbr/\u003eThe claimant receives a visit to asses her income, amount of land she has (whether owned or rented), accessibility to health services, how many meals she eats each day, access to fuel for cooking, what is her house made from (mud or brick), previous birth experiences and other factors which determine her socio-economic position.   \u003cbr/\u003eOnce a woman fits all the criteria another visit is paid to her home by the CBD to ensure all information provided is correct. \u003cbr/\u003eChristine Namayanja, OBA Project co-ordinator, says the scheme not only provides a safe place to give birth but also pre and post natal care and support.\u003cbr/\u003eMany women still give birth at home with the help of relatives or a Traditional Birth Attendants.\u003cbr/\u003eTraditional Birth Attendants like Alice Mugumya often have no formal medical or midwifery qualifications. \u003cbr/\u003eMost are simply mothers who have themselves given birth to many children and therefore have much experience in childbirth. \u003cbr/\u003eThey, however, charge for their services an average of 20,000 UgSh ($11) over 10 times more than the services offered by the Marie Stopes' voucher.\u003cbr/\u003eBut Alice has found a way to benefit from the trend for more formal healthcare. \u003cbr/\u003eShe has been selected by her local health clinic to train to be a qualified midwife. \u003cbr/\u003eAccording to UNICEF, since 1990, the base year for the Millennium Development Goals, an estimated 10 million women have died from complications related to pregnancy and childbirth, and some 4 million newborns have died each year within the first 28 days of life. \u003cbr/\u003eUNICEF say that advances in maternal and neonatal health have not matched those of child survival, which registered a 27 per cent reduction in the global under-five mortality rate between 1990 and 2007.\u003cbr/\u003eIn 2007 the mortality rates amongst under fives in Uganda was 130, that is the probability of dying between birth and exactly five years of age, expressed per 1,000 live births, according to UNICEF'S 2008-2009 State of the World's children report.\u003cbr/\u003eUganda was ranked 21 in the world in terms of the highest rates of under five mortality.\u003cbr/\u003eUNICEF say that child mortality estimates for 12 countries in Eastern and Southern Africa (Botswana, Lesotho, Malawi, Mozambique, Namibia, Rwanda, South Africa, Swaziland, Uganda, the United Republic of Tanzania, Zambia and Zimbabwe) were revised to reflect UNAIDS estimates of child deaths due to AIDS.\u003cbr/\u003eIn Uganda, where declines in maternal mortality have been registered, a review of emergency obstetric care facilities showed that in 54 districts out of 56 throughout the country, over 97 per cent of facilities expected to provide basic emergency services were not able to do so. Lack of running water, electricity, and functioning operating theatres were among the key impediments to service delivery, according to UNICEF'S 2008-2009 State of the World's children report.\u003cbr/\u003eThe OBA voucher scheme has also been widened to include treatment for men and women with sexually transmitted diseases. \u003cbr/\u003eThe STI voucher is a double card that admits two people. It entitles one to one counselling and education, diagnosis and four treatment schedules.\u003cbr/\u003e\u003c/span\u003e\n\u003c/div\u003e\n\u003cdiv class='action-container flex justify-between'\u003e\n\u003cbutton aria-expanded='false' aria-label='Read more description' class='rp-full-description' type='button'\u003e\n\u003ci class='fai fa-solid fa-align-left'\u003e\u003c/i\u003e\n\u003cspan id='read_more'\u003eRead More\u003c/span\u003e\n\u003c/button\u003e\n\u003cdiv class='rp-report'\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv aria-labelledby='resource-details-heading' class='rp-info-section'\u003e\n\u003ch2 class='title' id='resource-details-heading'\u003eResource Details\u003c/h2\u003e\n\u003cdiv class='rp-resource-details clearfix'\u003e\n\u003cdiv class='detail'\u003e\n\u003cdl\u003e\n\u003cdt\u003eCurator Rating\u003c/dt\u003e\n\u003cdd\u003e\u003cspan class=\"star-rating\" aria-label=\"3.5 out of 5 stars\" role=\"img\"\u003e\u003ci class=\"fa-solid fa-star 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