FEBRUARY NEWSLETTER: HOW WE WILL EXPAND THE BAMA PROGRAM FOR IMPACT

Esther and Moses and their twin daughters Nakato and Babirye

In 2022, we begin our 19th year serving the women and children of Uganda. Esther and Moses are among the one thousand teenage parents served by our Mama Ambassador Program. Their young children, Babirye and Nakato are now healthy 1-year old twins, but at 2-months of age, they suffered from severe malnutrition. Our program staff identified this life-threatening condition, which is all too common amongst Ugandan children, 30% of whom suffer from stunting in growth. The real hero of this story was Papa Ambassador Yiga Gaster. For the past six years, he has been a dedicated champion for the health and rights of women in our communities and it was Yiga, while facilitating one of our peer-support parenting groups, who referred Esther and her baby girls to our partnering nutrition center where they received the support they needed to ensure a return to health.

Papa Ambassador Yiga Gaster counseling a young mother

Partnering with district and national government, as well as the rural communities in which we live and work, we've learned so much about what is required to sustainably improve the health of women and children in Uganda. What has been the key to our success?

• Reducing institutional maternal and perinatal mortality by 72% and 44% respectively over the past 6 years

• Increasing the met need for comprehensive obstetric care from 53% to 76%

• Screening nearly 10,000 women for cervical cancer in 2021 and providing over 2000 HPV vaccinations to out-of-school girls through our Mother-Daughter campaigns.

• Transporting almost 6000 women in labor through our Mama Rescue Project, while reducing the time of emergency referral from 3 1/2 hours to 55 minutes!

All of our programs are low-cost, high-impact, evidence-based solutions ensuring access to quality maternal, reproductive, and newborn care. Each year, we learn more about human and client-centered program design, and as we do our effectiveness and ability to improve our interventions is strengthened.

By far, the most important lesson learned over decades of work is that real change is built by gaining the trust of local communities and of the over 300 midwives and physicians who care for our families. Building relationships of mutual respect has allowed us to integrate our health innovations into the existing health delivery system inspiring our local partners to continue to improve the quality of care for our communities.

Since the founding of the Babies and Mothers Alive Program in 2016, we have promoted our two districts as an innovation center of excellence in the delivery of quality maternal, newborn and reproductive health care. Increasingly we play a central role in the adaptation and adoption process in Uganda to develop and spread new approaches that can significantly improve health outcomes. We envision a process within Uganda where the Rakai and Kyotera Districts serve as lead innovation zones, where we are able to leverage the capabilities and relationships we have built through the BAMA Program to experiment, develop, and prove the potential of new programs such as the Mama Ambassador Program and Mama Rescue and by finding ways to deepen their impact. We are now ready to promote our innovative model. BAMA’s robust monitoring and evaluation systems afford the opportunity to provide credible evidence for what is working and what is not.

The next phase of our scaling process is to leverage our longstanding relationships and goodwill, as well as the measurable health impact in Rakai and Kyotera expanding our innovative model to a group of two early-adopting districts, representing a diversity of contexts and demographics. Results in these second-stage districts, together with the lessons learned that enabled their successful adoption and adaptation, will set the stage for the third phase of national integration of those interventions. In order to accomplish this longer-term goal, we will also be engaging the Ugandan Ministry of Health and other government and non-government stakeholders to adapt and adopt the BAMA model.

In the coming months, we will continue to share our Transition to Scale vision with you. As we have evolved into a leader and change agent in maternal and child health, we will be transitioning from Brick by Brick to Babies and Mothers Alive. That 're-branding' will afford us new opportunities, a re-designed website, and social media platforms.

2022 looks like it's going to be an exciting year of growth and change. As always, we thank you for being one of our most valued partners.