Work in progress

March 2020

 

PAKISTAN

MATES-iN was invited by the board of two hospitals and a Mother and Child Healthcare unit (MCH) in Lahore, to investigate the deficit of the MCH unit. The main problem was that deliveries rarely took place in the MCH.
Arriving in Lahore we found an attractive looking MCH unit in a busy area close to one of the hospitals, run by three midwives (Midwifery Led Care) offering general, prenatal and natal care.
All the stakeholders involved were identified and, based on the quality framework published in the first article of the Lancet series (2014), we designed questionnaires and observation lists needed to give insight in the functioning of the MCH unit.
Subsequently a wide range of stakeholders were interviewed: actual and former clients, TBA’s (traditional birth attendants), LHW’s (lady health workers) , administrator, midwives, nurses and gynaecologists, the CEO of the hospitals, of the midwifery association and midwifery training institutes. Next to this, we spent time on observations in the MCH and on the wards of the hospital.
In the end the outcomes were summarized. E.g. people were not familiar with the institute of a MCH unit run by midwives outside of the hospital, this concept was not known before in Lahore and also the low status of midwives appeared to be one of the impediments. Finally advices based on the outcomes and three options for operational plans were presented.
Next to this Medicare Health Foundation asked us to provide a training for midwives in order to enhance their knowledge and skills. Based on a confined TNA (training needs assessment) we provided 4 workshops in two days. The subjects were: hypertension, PPH (postpartum haemorrhage), IMBFC (International MotherBaby-Family Maternity Care) & WHO intrapartum guide and non-pharmacological pain relief, all based on WHO guidelines.
The room available for the training had a maximum capacity of 23 and was fully booked by enthusiastic and inquiring midwives. We can look back on a successful training. We are kept informed of progress of the MCH unit and provide support if necessary.

This feedback we received November 6th:
“On behalf of the entire team of Medicare Health Foundation, we thank you from the bottom of our hearts for the incredible work you did in identifying the gap areas in the MCH. Your meticulous work has provided us the insights and motivation for bringing about the recommended changes to make the purpose of the MCH more effective. We will definitely act on your suggestions, and are sure that they will bear fruit”.

COLOMBIA

Since September 2018 MATES-iN is part of a consortium. Together with the Dutch government and other Dutch enterprises like Hospitainer, Greenlink, Medrecord and NLWorks, we support the Colombian government to achieve sustainable development by implementing Healthy Villages. In a healthy village, people have access to health care, electricity, and clean water. Hospitainer provides a health post or health center where the community can be treated, children can be vaccinated and where pregnant mothers come for antenatal care. Combining this with other modules for example solar panels, communication technology, and water sanitation we will involve the local people in installation and maintenance so they have more resources to earn an income. To improve the quality of care MATES-iN will build the capacity of local health professionals working in rural areas. To explore the possibilities of collaboration we visited Colombia in November 2018 as part of a trade mission in the presence of our premier, Mark Rutten. The first Hospitainer is established in December 2019 and MATES-iN is preparing modules for the training of auxiliaries, community health workers and traditional midwives in collaboration with the staff of the Hospital and health secretary in Puerto Inirida in Guainia.