Saturday, 29 April 2017

Guest blog from Jack Andrew

Hello All!

This is Jack Andrew here. Joy has kindly given me opportunity to write a guest post for her blog so here I am! A little information about me and why I’m here to begin with before I delve into my experiences with the MOMENTUM project in Uganda.

I am the RCM's data analyst, a job which I fulfil part time as I'm a keen sportsman and still compete in the decathlon both nationally and internationally. I was given the chance to travel to Uganda with the RCM’s MOMENTUM project team through a career development opportunity advertised internally.  Admittedly I am no expert in midwifery, international development or Uganda but I got the travelling bug a few years back and have enjoyed experiencing new places and cultures ever since. I saw this as a golden opportunity to experience part of the world I had never visited from a completely unique perspective, so I applied and it turns out it was possibly the best 300 words I ever wrote!

Jack's first official meeting in Uganda with Joy Kemp (RCM Global Professional Advisor), Catherine Odeke (Centre: Ugandan Commissioner for Nursing and Midwifery, Ministry of Health) and Sarah Najego (Right: UPMA Monitoring and Evaluation Officer)

I left Uganda yesterday after a busy final day capturing some more videos  of key stakeholders, saying my goodbyes to the friends I have made during my visit as well visiting the slum with RCM member Diane Lockhart. I am currently sat in Brussels airport on a three hour layover trying to put fingers on keys about my experiences and what I have learned. Unfortunately I don’t think it has all sunk in yet but I’ll do my best to get what has down for you.

The past week has been a very steep learning curve for me not just in terms of how the MOMENTUM project has run and trying to understand the impact it is having but also in maternity services in general (let alone maternity services in Uganda!). Joy and Eleanor have been tremendous in helping me get up to speed with the project, explaining maternity services, giving me a heads up on local customs and introducing me to the key stakeholders so after just a week I felt I had good overview of the project and its intended impact.

Jack meeting the RCM's partners, The Uganda Private Midwives Association, for the first time and understanding the process of developing the Inception Document for the Final Project Evaluation.  The evaluation is being undertaken by an external team with both Ugandan and UK consultants

It’s been a very busy week with some long (lunch-less) days which admittedly was a struggle at first as I'm so used to regular consuming  vast amounts of food at home due to my decathlon training. I’ve had exposure to all levels of the Ugandan maternity services, from meeting with Commissioner for Nursing and Midwifery at the Ministry of Health to visiting families in the slum. Meeting key stakeholders at MOMENTUM project pilot sites in the government health centres and UPMA clinics was a fascinating experience even for someone with limited knowledge of maternity services.

The MOMENTUM project is coming to a close at the end of this month and although I haven’t been involved all the way through I was lucky enough to interview almost all of the key stakeholders and hear their views on the impact the project is having. Different stakeholders had encountered different challenges during the course of the project, but were all united in the fact that they all had such positive things to say about the impact of the project, the changes it is starting to bring and the working relationship they have developed with the RCM.

Jack and Joy visit Robinah's maternity home.  Robinah and two of her staff have been trained as mentors during the MOMENTUM project and have now mentored 4 student midwives for their domiciliary placement

Jack doing video interviews with Robina and Rose, two midwives in government service at the Wakiso Level IV Health Centre.  Robina was twinned with UK consultant midwife Kade Mondeh during the MOMENTUM project and they communicate regularly via Whatsapp.  Robina and Rose have both been trained as mentors, along with 3 other midwives and have now mentored many studentmidwives.  The clinic has also been upgraded with solar lighting and basic midwifery equipment to enable the clinic to work safely 24/7 and the students to practice all the necessary skills to become competent midwives.  Quality of care has also improved; many more women are coming to birth their babies at the Health Centre and far fewer women and babies are being transferred out for sepsis or asphyxia

For me the highlight of the trip has to have been the people. The people of Uganda are so friendly and seemed happy to stop and talk at any time of day. Although this did prove to be a bit of an issue during the walking tour we took around Kampala at the weekend as I was often left 20 paces behind the group after becoming engrossed in a conversation with a local about English football, I wouldn’t have changed it for the world. I also had the chance to meet two RCM members, Diane Lockhart and Rachel Haddock (Fishy),both incredible people, both based in Uganda and both doing some amazing work out here.
Jack saying goodbye to new friends: Lamula (left, UPMA's secretary) and Bonny (right, UPMA's driver)

RCM Member Diane Lockhart from Northern Ireland, living in Uganda long-term and working in a Kampala Slum.  MOMENTUM donated her a new fetal doppler which was immediately put to good use with a client in her slum clinic.  Jack had the opportunity to visit the slum, meeting families in their homes and sharing a plate of matoke (steamed plantain) with the chief, 'Mr Chairman'.

Joy with RCM member Rachel Haddock (Fishy) who lives in Uganda long-term works in a community health outreach project in Jinja.  RCM staff try to meet up with Fishy on every visit and provide a listening ear.  We also supported her to revalidate with the NMC last year by acting as 'confirmer' for all her documentation.

Jack saying goodbye to midwife Mary, UPMA's president

It’s also been nice to get out and do some training sessions on the Kampala hills, the temperature at 6:30am was very pleasant and perfect for getting an early morning session in, that said I did have to run in a monsoon one morning!

Anyway thanks for reading, I feel like the above has only scratched the surface on my time in Uganda but I hope it’s been informative none the less. I am also hoping to put together a short video about the MOMENTUM project and my time away here so stay tuned for that!

Thursday, 20 April 2017

Closing out the MOMENTUM project

I'm in Uganda again for 2 weeks to close out the RCM's MOMENTUM project (Developing a Model of Mentorship for Ugandan Midwifery).

Opening meeting with our partners UPMA and the Ugandan project evaluation team
MOMENTUM is a twinning project between the RCM and the Uganda Private Midwives Association.  However, we've also been working closely with the Ugandan Nurses and Midwives Council, the Ministries of Health and Education, various universities and midwifery training schools and seven clinics or health centres.  The project aimed to develop a national standard for midwifery mentorship, to develop a work-based learning module to train midwives as mentors (and test the module by training 40 mentors) and make improvements in 4 clinical pilot sites (8 clinics, a mixture of government, faith-based and private facilities).   Our team of 7 UK midwives have completed their assignments and all our targets have been met.  Our team is here to collect the last of the data, to conduct a closing workshop presenting the model to all the stakeholders, to coordinate the final evaluation, to undertake some qualitative research and to generate ideas for follow-on projects.  
New solar light at Mukono Level IV Health Centre installed by the MOMENTUM project - 20 deliveries a day and previously delivering babies by candlelight when the power was off.  One candle nearly caused a catastrophic fire.  Now students can get experience of conducting deliveries round the clock
Alex, lead midwife, proudly showing us the solar light switch

Our team is comprised of 3 RCM staff members: Eleanor and I from the global team and Jack Andrew, the RCM's data analyst, here as a career development opportunity and also helping us with data collection and analysis and by making a video about the project.   Eleanor's partner Sean and baby Etta are here with us too so it's lovely having a baby to stop us working too hard in the evenings.  Apart from working for the RCM Jack is a Decathlete with the British Athletics Team so he's used to training a lot and eating lots of healthy food at regular intervals.  The long lunch-less days and lack of fruit and veg are challenging him; today we had to make an emergency stop at a hotel when Jack turned pale and wan!
Always an important visit at the start of our trip, to make sure that our programme continues to align with MOH priorities and to meet important officials who can ensure the sustainability of the project's outputs
Jack and I meeting with Catherine Odeke, the Commissioner for Nursing and Midwifery at the Ministry of Health.  Sarah (UPMA's M&E officer) on the right.

 Tomorrow we are meeting with midwife tutors and visiting one more clinic.  Jack will spend some time in a Kampala Slum with RCM member and midwife Diane Lockhart, working there doing an incredible job.  Also 'Fish'y (Rachel Haddock) another UK midwife and RCM member will join us for the weekend.  It's great to connect with our international members and offer some encouragement whilst we're in-country.
With Rogers, Brenda and Patrick, tutors from the Mukono Diocese School of Nursing and Midwifery

Jack videoing Robina and Rose, two midwives who have been trained as mentors at Wakiso Level IV Health Centre

Sarah Mwanje, Private Midwife and trainer mentor, proudly showing her trainer's handbook

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