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MANIFEST Study Shares Preliminary Lessons From Implementation

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Future Health Systems is a research consortium working to improve access, affordability and quality of health services for the poor. We are a partnership of leading research institutes from across the globe working in a variety of contexts: in low-income countries (Bangladesh, Uganda), middle-income countries (China, India) and fragile states (Afghanistan) to build resilient health systems for the future. After a successful first five-year phase from 2006-2011 (see our success stories), we are entering a new six-year phase of research, funded mainly by UK aid.

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MANIFEST Study Shares Preliminary Lessons From Implementation

Future Health Systems

By Kakaire Ayub Kirunda

It is the final 9 months of implementing the three year Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study in eastern Uganda and the preliminary results are interesting.

Three progress briefs have just been produced by the Uganda Team of the Future Health Systems Research Consortium, and the preliminary findings show remarkable achievements across the three thematic focus areas/components of the study.

From the community mobilisation and sensitisation component, the preliminary lessons show that Community health workers, also known as Village Health Teams (VHTs) are an important resource for community mobilization and health information. Progress Brief No. 1 shows that from January through September 2014, VHTs reported 145 low birth weight babies and 145 (12/1000 births) newborn deaths compared to 93 newborn deaths reported by facility based HMIS. The same reporting period also saw 27,522 pregnant women and 11,752 newly delivered women being registered and visited by the VHTs. This implies MANIFEST has achieved 89% of the target for pregnant women (39,230/43848) and 19% of the target for visiting newly delivered women (15,543/43,840).

Under the savings and transport component, as indicated in Progress Brief No. 2, it is emerging that when communities understand the importance of saving money for use during pregnancy and after birth, they are willing to save money for this purpose. And, as at the end of 2014, up to 1006 saving groups (Kamuli-426, Kibuku-264, and Pallisa-316) with a maternal and child health component had been registered in the three districts.

Meanwhile, Progress Brief No. 3, focusing on mentorship under the health systems component, concludes that despite the challenges, mentorship is an important channel for skills transfer and enhancing professionalism among health workers and may contribute substantially towards the quality of care provided. It also provides an avenue for supporting critical thinking, health worker motivation and strengthens teams.

None-the-less, it was not all smooth sailing. As noted in the three progress briefs, there were some challenges, such as the waning spirit of voluntarism among the community health workers, among others.

The MANIFEST study team has also produced its first issue brief aimed at encouraging the use of partographs by midwives and health workers involved in delivering women.