The scope: World Vision Uganda working with other partners like ANDIC invested in the implementation of a community behavioral change model for maternal newborn and child health (MNCH) in 15 sub-counties of Hoima and Kikuube districts, Uganda between 2015 to 2019.
Rational of the work: TTC was conceived to address knowledge and attitude gaps and promote timely consumption of health services for the good of the mothers and their children. Before the project, most pregnant mothers lacked adequate knowledge on the benefits of attending ANC and delivering from the health facilities. Most of the mothers would only seek health services at the time of delivery while others would deliver under the care of traditional birth attendants.
The experiments conducted: A village health team (VHT) functionality assessment was conducted to inform action areas. The project engaged in trainings for supervisors and VHTs in the basic and TTC package and equipped them with necessities for work. VHTs mapped pregnant, lactating mothers and children under 2yrs with whom they conducted routine ttC household counseling sessions and dialogue for key MNCH behaviors. Monthly coordination meetings at the health facility and parish level were supported to strengthen facility community linkage and reporting. To retool VHTs in TTC, radio distance learning an innovative cost-effective approach was introduced. Runyoro TTC audio episodes were developed and aired on radio for VHTs to listen in through their listenership groups of 10-15.
Results and the findings. Project evaluation indicated that VHT functionality index improved from44.1% to 71.5%. A total of 2,058 ttC-VHTs reached out to 74,224 households, the observed MNCH behavioral changes are attributable to their work. The women who attend the recommended 4 or more ANC visits improved from 30.7% to 61.4%. HIV testing during ANC visits increased from 56.4% to 76.3% while skilled birth attendance increased from 55.5% to 89.0%. The newborns who received postnatal checks within 48 hours of birth increased from 24.0% to 54.5% while full immunization for children aged 12 to 23 months increased from 80.0% to 90.3%.
Keywords: Timed and targeted counseling, Village health team, Maternal newborn and child health, Radio distance learning