Autore: Redazione Cuamm

Drought hindering women and newborns’ well-being in Cunene province

Posted on by Redazione Cuamm

Newborn healthcare remains one of the primary constraints faced by CUAMM’s team at Chiulo Catholic Hospital due to lack of dedicated spaces, equipment and trained personnel. Moreover, physical barriers for institutional delivery are increasing the risks of newborn complications other than jeopardising maternal health. The prolonged drought has led to an increase rate of acute malnutrition among under 5 and it is strictly intertwined with infectious disease, more commonly widespread due water scarcity, resulting in half of children in drought provinces showing at least one sign/symptom of infectious disease (diarrhoea, fever or cough). The high level of malnutrition among PLW are worsening health outcomes since the first days of life of newborns. Poor dietary diversity and micronutrients deficiency in pregnant women is also contributing to high malnutrition rates among children <5.

In Cunene province, CUAMM and Manos Unidas join efforts in favor of women and newborns by providing integrated health and nutritional services at Chiulo Catholic Hospital.

In order to better manage newborns and paediatric’s complication at hospital level hence reduce newborns and pediatric complications, a dedicated intensive care area is being constructed within the paediatric wards. Furthermore, renovations at the maternal waiting home – casa de espera, will facilitate access to safe delivery for a a major number of women. Education is also a milestone in the intervention: to enhance caretakers’ knowledge, the project will support awareness raising sessions and cooking demonstrations at hospital level while also supporting the construction of an outdoor kitchen.

«Malnutrition is caused by a significant imbalance between nutritional intake and individual needs. It is most often caused by both quantitative and qualitative deficiencies  – said Ndapandula Wilca, chief nurse at the maternal waiting home. Here at casa de espera (maternal waiting home) in Chiulo hospital we organize cooking demonstration to engage women in sensitization activities. By teaching them how to make the most out of what they have at disposal we can prevent malnutrition».

The intervention will directly benefit 1.976 recipients while reaching an overall number of about 300.000 people in the drought-affected province of Cunene.

The prolonged drought in the south of Angola has led to more than two million children in need of humanitarian assistance, 1.2 million people in need of water availability and in 1.58 million people facing acute food insecurity in South-western Angola (WFP, June 2023) and about 15% of the population in Emergency (IPC Phase 4) (2022). The impact of drought on the livelihood opportunities dominated by agriculture and livestock has also adversely affected the nutrition status of the population being pregnant and lactating women (PLW) and children under 5 years of age the most vulnerable groups.

Cunene Province is among the provinces in the country with the highest prevalence of insufficient food consumption. The province experienced below-average production, resulting in higher market dependence amid higher food prices and relatively lower livestock prices. Despite the slight improvements registered in the past months, according to Relatório Avsan 2021, Cunene is among the regions with the highest malnutrition rate with Global Acute Malnutrition – GAM at 7.9% in Cunene (the prevalence of Severe Acute Malnutrition – SAM and/or oedema is 1.4% and Moderate Acute Malnutrition – MAM at 6.5%).

Doctors with Africa CUAMM is working at Chiulo Catholic Hospital, to contribute to improve the nutritional and health status of newborns, and pregnant and lactating women in line with the SDGs 2.2 and 3.3. The intervention, supported by Manos Unidas, aims to reduce newborns and pediatric complications through the construction of a dedicated intensive care unit within the paediatric wards. Proper equipment and trained healthcare workers will improve the management of newborn and pediatric care at hospital level. Furthermore, the upgrade of a maternal waiting home, casa de espera, will increase the number of women with access to safe delivery, thus reducing newborns, pediatric and maternal complications. Moreover, awareness activities among caregivers, PLW and caretakers on health, hygiene and nutrition practices will facilitate prevention and treatment of acute malnutrition hence improve health outcomes.

 

Backstage of essential health services

Posted on by Redazione Cuamm

What is behind the essential health services provided to the population in the most fragile settings? Behind the concrete delivery of services, there are very delicate skills and activities: the timely supply of drugs and medical equipment, the complex infrastructural improvements in fragile situations, the capacity building of local workers, often far from regular training systems.

In the Gambella Region of Ethiopia, a ‘transformational’ pathway is in place to improve essential health services, particularly for mothers and children, by strengthening the Health Management Information System (HMIS). This process requires honing articulated skills such as data collection, analysis and utilisation, so that those managing health services can make more informed decisions and thus provide higher quality care to the population. In addition, an effective data management system is crucial for tracking the progress of project-implemented activities and flagging any critical issues, thus allowing actions and strategies to be re-oriented in a more appropriate manner.

This is one of the components of the technical assistance provided within the “INCLUSIVE: Strengthening Prevention, Equitable and Inclusive Care for All” project that supports 9 health facilities, 2 hospitals and 7 health centres in three districts of the Region: Gambella Town, Gambella Zuria and Abobo. The focus of the intervention is maternal and child health care, with special attention to prevention and the creation of a favourable health environment for people with disabilities. Financed by the Italian Agency for Development Cooperation, the intervention is implemented by Doctors with Africa CUAMM together with CBM International and Rehabilitation and Development Organisation (RaDO).

“Improving information utilisation platforms and data monitoring practices is crucial today, in order to manage the day-to-day work in a more timely manner, but also for the future, to more effectively inform health initiatives and improve services. The progress made so far highlights the importance of collaboration, training and dedicated support,” says Buzuayehu Bogale, Cuamm expert for project monitoring and evaluation.

Based on an initial analysis, an action plan was developed for each health facility involved through targeted staff training and supervision activities. Among the main results achieved, staff improved their ability to validate data and prepare accurate reports from DHIS2, the national district-level health information collection software; as well as to monitor performance using key indicators (KPIs), to regularly update the system and to use monitoring charts. Investing in the health information system is investing in improving the quality of services and their sustainability: it is the other, more hidden side of caring for patients.

 

CUAMM recognized by WHO for its commitment in controlling NCDs

Posted on by Redazione Cuamm

«For the work done in the improvement of health outcomes in rural areas in Tanzania as for the dedicated commitment in supporting local and forgotten communities» stated the United Nations Inter-Agency Task Force on the Prevention and Control of Non-communicable Diseases (NCDs) to justify the assignment of the Task Force Awards 2024 to Doctors with Africa CUAMM. Such prestigious award recognizes actions and approaches driven to preventing NCDs and promoting universal access to assisting technology.

CUAMM received the award for its commitment in Tanzania. Over the last year in fact, we have carried out an integrated project for the prevention and treatment of diabetes and hypertension in the Iringa DC District and at the Tosamaganga Hospital, with the hospital acting as the district’s referral facility for the diagnosis and care of chronic patients and peripheral facilities supporting treatment and follow-up. The “Friends of the Task Force” award ceremony was held today on the margins of the 79th session of the United Nations General Assembly.

«This important award is being assigned to recognize the commitment in improving health outcomes in Tanzania and assisting marginalized communities – says Gaetano Azzimonti CUAMM Program Manager in Tanzania -. Our work on non-communicable diseases ensures that people living with chronic conditions have access to the health services they need all life-long. We do so by localizing health services therefore enabling people living in rural areas to acceed the care. This work is being done in the health centres located all-over Iringa district. This award encourages us to keep up the work and to continue and recognises an innovative intervention, which involved many local health professionals, from the Tosamaganga Hospital to the peripheral health units’».

Doctors with Africa Cuamm was awarded in the NGO category, along with three other organisations, and the award ceremony took place on the sidelines of the 79th session of the UN General Assembly in New York.

CAR Expanding Intervention in the Country’s Last Mile

Posted on by Redazione Cuamm

The Central African Republic ranks 188th out of 191 countries on the Human Development Index. Marked by significant instability, conflict, and armed violence, it has a large number of inhabitants living in extreme poverty: 500,000 people are displaced, about 3 million people did not have enough food in 2023, and 2.4 million are in extreme need.

In such a problematic situation, Doctors with Africa CUAMM, thanks to the support of the European Union, expands its efforts to bring an integrated and cross-cutting health response to the sub-prefecture of Koui, supporting the second-level hospital and the four health centers in the area, to redistribute the patients of the nearby hospital of Bocaranga, so far the only functioning one.

Special attention is given to childbirth and newborn care and malnutrition, especially in children under the age of five. Equally important is the training of health personnel, community outreach, and a great deal of work on youth and women who have experienced violence and abuse in an area characterized by the presence of many armed groups.

About 80 km from the hospital in Bocaranga, where Doctors with Africa CUAMM already have a presence and are involved in responding to emergencies, is the Koui hospital, which serves more than 160,000 people. Basic essential services are lacking here, and those that are present are difficult for the population to access. 

Reaching the last mile of the healthcare system, those often forgotten outskirts of the world, is a deep commitment for CUAMM, embedded in the DNA of an NGO that has been working with Africa for over 70 years. After initiating its presence in the country by engaging with the Pediatric Complex in the capital, Bangui, CUAMM has chosen to operate in areas such as Bocaranga and Bossangoa.

Now, this new project aims to rehabilitate the hospital in Koui, reorganizing the space to provide better care and relieve the hospital in Bocaranga. Already, the first data collected are encouraging: in the first months, 2,754 outpatient visits for children under five years old; 104 assisted deliveries; 355 prenatal visits; 484 hospitalizations; 142 children vaccinated within the first year of life; 229 people reached by health education messages.

The intervention includes the renovation of the operating room, the maternity ward, and the electrical and plumbing systems; the improvement of waste disposal procedures; and the construction of latrines. CUAMM will also ensure the supply of medicines and medical materials, as well as the necessary equipment for the various departments. To meet the needs of the population, new healthcare staff will be hired, and training and updates will be provided for those already employed. Lastly, a transfer system for more complicated cases and emergencies, particularly obstetric ones, will be implemented through motorcycles, operating from the outskirts and villages to the hospital.

The intervention titled “Project to Respond to the Health and Multidimensional Needs of People Affected by the Humanitarian Crisis in Ouham Pende Prefecture” is co-funded by the European Union through the Directorate-General for European Civil Protection and Civil Aid Operations and will be implemented by Cuamm in collaboration with Ofhard (Women’s Organization for Humanitarian Action and Sustainable Development), a local NGO.

 

EU Civil Protection and Humanitarian Aid:  The European Union and its Member States are among the world’s leading donors of humanitarian aid. Relief assistance is an expression of European solidarity with people in need all around the world. It aims to save lives, prevent and alleviate human suffering, and safeguard the integrity and human dignity of populations affected by disasters and human-induced crises. Through the Directorate General for European Civil Protection and Humanitarian Aid Operations of the European Commission, the European Union helps millions of victims of conflict and disasters every year. With headquarters in Brussels and a global network of field offices, the EU provides assistance to the most vulnerable people on the basis of humanitarian needs.”

 

Improving access to HIV services among adolescents

Posted on by Redazione Cuamm

Mozambique is one of the African countries with the highest HIV prevalence, with a national average of 11.5% (UNAIDS 2020). As of 2020, 2.1 million people were estimated to be living with HIV in Mozambique, with a higher prevalence among adolescent girls (ages 15-19) and young women (ages 20-24).

Youth and adolescents were the direct recipients of an intervention planned to improve access to HIV services in 9 SAAJs (Serviço Amigo do Adolescente e Jovem) in Beira city and Nhamatanda district. Implemented by CUAMM with the support from Manos Unidas, the intervention aimed to educate young people/adolescents (ages 10-24) about safe sexual behaviours, encourage (voluntary) HIV testing, improve access to and quality of HIV healthcare services for adolescents/youth, and ensure adherence to ART, particularly for pregnant and breastfeeding HIV-positive women.

To enhance access to sexual and reproductive health services (SRH) and reduce HIV incidence among adolescents/youth, CUAMM has used an approach based on integrating different levels of intervention, namely health units (SAAJs) and communities, creating links between counselling, testing, and treatment and engaging local peer-to-peer associations and community based organizations (CBOs).

«So many people around us are widely considered crazy and excluded from the community with severe consequences on their life. What is not known is that people are not crazy, they are just going through something difficult and may not be able to cope with it. That is why mental health is important and caring, accepting and supporting the suffering others are experiencing can help them healing» Marina Castaneja – activist from Kuplumussana Association.

The intervention’s objectives were designed to meet the programmatic priorities and targets established by the Government of Mozambique in the National HIV Response Plan. The activities, carried out in collaboration with local authorities both at provincial and district level, showed positive results. In the last 13 months alone, a total of 44.858 HIV tests were performed allowing to detect 404 new HIV positive cases. Despite an early 28% of people in TARV who abandoned the follow-up, 98% of them returned to the treatment thanks to the collaboration with CBOs and peer-to-peer activities.

In addition to the three components previously integrated to the approach, namely involvement of clinical officers, participation of CBOs and provision of mental health and psychosocial support (MHPSS) for patients in TARV, the main activities implemented focused on:

1) Strengthening access to and quality of HIV services (SAAJs) in the Beira and Nhamatanda Districts,

2) Increasing HIV and SRH knowledge and awareness among adolescents in the target area,

3) Improving the Health Information System.

The project did not fail to include trainings as a tool to enhance competencies among professionals, thus ensure the sustainability of the intervention over time. Health professionals/managers got involved in training sessions to foster their capacities in case diagnosis and management as well as data collection and analysis skills.

Despite the country in the last years made progress on HIV and AIDS (UNAIDS) 95-95-95 goals, with 82% of PLHIV aware of their status, gaps remain among adolescents. Estimates suggest that Mozambique has 98,328 new HIV infections annually, and 28.7%, (28,220) are among adolescent girls and young women compared to 11.4% (11,209) among men in the same age group. Within Mozambique, the Province of Sofala is one of the worst in the country for HIV prevalence, which stands at 16,3 % (IMASIDA).

«We have to keep working with the youth because they are extremely fragile. Adolescents are highly sensitive to peer values and opinions, being accepted is in fact a key component of the phase they are living. Due to stigmatization and discrimination related to HIV, by receiving a positive diagnosis young people can experience panic and depression. We have to support them and help them cope with the diagnosis not only from a medical perspective but also psychological» said Hamilton Cardoso – CUAMM psychologist.

Since 2014, Doctors with Africa CUAMM has been implementing a patient-centered HIV case management system, with a focus on supporting adherence of HIV+ pregnant adolescent girls and tracking defaulter patients. Moreover, a new service of MHPSS was introduced lately in order to respond to the negative consequences on the mental wellbeing of adolescent and young people due to the impact of disasters and emergencies like Cyclone IDAI and the Covid Pandemics. Indeed, in a study conducted with more than 2,000 adolescents and young adults in Beira, CUAMM found that approximately 54 were positive at least at one screening tool for anxiety, depression, PTSD (Post Traumatic Stress Disorder) and drugs-alcohol abuse.

 

Future doctors in Mozambique

Posted on by Redazione Cuamm

Patience, humanity, trustworthiness, affability, and empathy, along with an indispensable dose of professionalism.

For Atianete, Hercília, Muaziza, and Victorino, these are the qualities that a medical professional should embody, and ones they hope to maintain throughout the years of practice ahead of them. This is what they revealed to us when we meet them in Beira, at the headquarters of the Catholic University of Mozambique (UCM). They are four of the 44 newly graduated doctors in general medicine, who were just declared doctors the day before by the Magnificent Rector, Professor Father Filipe Sungo. It was a grand ceremony that brought together professors, students, friends, and families in a day of celebration and emotion.

In his speech, the rector of UCM, Professor Filipe Sungo, thanked the students for their dedication, the professors for their commitment to teaching and continuous research, the families for their unwavering support, and the partners, including CUAMM, for their ongoing collaboration. “This achievement, which is yours,” said the Magnificent Rector in front of an audience of 893 students, “is also a testament to the collective effort that unites us as an academic community.”

We meet our four scholarship recipients a few days after the celebrations. Their smiles and teary eyes betray the strong emotion of having reached such a long-desired milestone. It’s a contagious feeling that also reflects on our faces, and when Victorino, with a soft voice and a hint of embarrassment, says “My name is Victorino Fernando Junior, I was a medical student, today I am a general practitioner,” we can only respond with a heartfelt round of applause. Over the past eight years, Atianete, Hercília, Muaziza, and Victorino have spent most of their time between the UCM classrooms and the library, keeping their commitment and determination alive even during the most challenging periods.

“It hasn’t been an easy journey, we must admit, which is why today we are doubly happy about the goal we’ve achieved,” says Hercília, her eyes shining with satisfaction. “Eight years is a long time, the cyclone first, then the pandemic—moving forward wasn’t easy. Studying requires consistency and method, and we found ourselves having to start over so many times! The passion for this work and the support of the people who believed in us were the driving forces during the hardest moments.”

Four young doctors, four stories of commitment, and four paths still to be walked. Sitting in a small classroom at UCM, we start talking until the initial embarassed is over. Difficulties and motivation, expectations and desires is what we have shared in a long conversation.

“I thought I was more suited for IT,” confesses Victorino. “Medicine seemed like an enormous commitment; I would have had to give up much of my personal life. This faculty is like a girlfriend, it wants all your time! What convinced me? Maybe my mother’s threats. After a bad accident, it was she, a nurse, who took care of me for months. She never missed an opportunity to point out that if it hadn’t been for her training, it would have been much harder to get through that period. Today, I owe her the joy of this degree.”

The shortage of qualified healthcare professionals is, in fact, one of the biggest obstacles to the full development of the national healthcare system in Mozambique. According to the latest data (WHO, 2022), the country has 2,473 doctors for a population of 30 million people, with only 778 being specialist doctors. The average is 0.8 doctors per 10,000 inhabitants, two-thirds of whom are employed in the capital, Maputo.

“Now the clinical work begins. In Mozambique, it is mandatory to serve two years as a general practitioner before potentially specializing. We can express preferences, but it’s not guaranteed that we will be assigned where we want. Some stay in the cities, others are sent to the districts, but in any case, it will be a useful period to better understand what we want to do,” says Atianete, who hopes to move to Maputo to continue specializing in emergency medicine.

Specialization is a shared desire: Victorino will have to decide whether to become a pediatrician or a gynecologist, Hercília is sure of her passion for surgery, and Muaziza dreams of becoming Mozambique’s first endocrinologist.

Doctors with Africa CUAMM has been committed to supporting the Catholic University of Mozambique since its foundation in 1995, contributing to the establishment of the Faculty of Medicine, the second in the country. Until then, medical studies could only be pursued in the capital, Maputo, making a medical career difficult to access for those from other provinces.

“Studying away from home is challenging in many ways: you have to deal with loneliness, financial difficulties, and do your best to honor the commitment you made because you know well that behind it there are many sacrifices: yours, your family’s, and those of those who believe in your dream,” says Muaziza, from the province of Nampula.

Since 2007, the year the first class of aspiring doctors graduated, Cuamm has continued to support the teaching activities of the UCM Faculty of Medicine, providing concrete assistance to the facilities (classrooms, laboratories) and equipping teaching materials (books, computers, etc.). The close collaboration on the curriculum is also significant, with visiting professors from CUAMM holding teaching modules at UCM. Additionally, within the partnership, internship opportunities are facilitated at Beira Central Hospital, research projects are promoted, and, most importantly, scholarships are offered to deserving students. This is a concrete example of cooperation that becomes a tool for the training of many students, and a bridge between distant academic realities. Every year, we renew our commitment, thanks to the support of those who, like us, wish to contribute to the dreams of young Mozambicans, the future doctors of this country.

Budget

The annual budget to support the costs of a scholarship amounts to 3,100 euros per student, broken down as follows:

Expense Category Annual Cost
Administrative fees for enrollment at Beira University 1,500 €
Subsidy for food and accommodation 1,200 €
Subsidy for purchasing educational materials 400 €
Fee for one year 3,100 €
Total fee for the entire study cycle (6 years) 18,600 €

What You Can Do

Join our commitment—thanks to you, we can carry out concrete actions that change the lives of many people. Support the training of local doctors.

DONATE NOW

 

Fostering capabilities among french speaking FBOs

Posted on by Redazione Cuamm

Access to training opportunities is a key step in empowering and strengthening FBOs, yet language barriers can lead to missed opportunities. In order to overcome such challenge and promote equal access to training, Doctors with Africa CUAMM has just held its first french-taught course on leadership and networking skills. The training followed the syllabus of the previous english edition, held in July.

  • “Opening remarks” Father Dante Carraro – CUAMM Director General
  • “Connect, strengthen and empower Faith-Based Organisations in delivering healthcare services” Mr. Andrea Atzori – Head of International Relations at CUAMM
  • “Supporting Faith-Based Organizations delivering Healthcare in Africa” Dr. Parotto – Clinical Advisor and Anesthesiologist, Padua’s University Hospital
  • “The cycle of the project” Mrs. Anna Cavestro – Project Manager
  • “Partnerships with Governments & Local Authorities: the experience of UCMB” Dr. Kasyaba – Assistant Executive Secretary of the Uganda Catholic Medical Bureau (UCMB)

    «Participants were encouraged to foster a culture of collaboration, to value the contributions of each team member, and to maintain open and transparent communication» stated the Diocesan Director at Centre de Charité Saint Camille de Djougou – Father Yvon Serge Hounsou from Ordre des Serviteurs des malades, Benin.

43 people representing 22 different faith-based organizations from 11 African countries attended the virtual training course organized by CUAMM thanks to the support of the Conrad N. Hilton Foundation. Professionals such as nurses, medical doctors and health facility’s managers were among the learners who were represented by both ordained and no-ordained members of religious congregations.

«This event was a valuable opportunity for participants from various religious institutes to strengthen their skills and knowledge. As the speakers shared their experiences and intervention strategies, we were able to learn in order to prepare ourselves to better serve our communities» said brother Cosimo, nurse from Ordre hospitalier de St. Jean de Dieu, currently serving at Saint Jean De Dieu Hospital Tanguiéta, Benin.

Since 2019, Doctors with Africa CUAMM has been committed to strengthening the capacity and resilience of staff working in faith-based health facilities across the Africa region by offering training packages on different topics including healthcare facilities management, clinical aspects, project management, disaster preparedness and resource mobilization. While the courses were only available in English until now,  “Compétences en matière de leadership et de mise en réseau” intends to facilitate access and learning to french speaking professionals deployed in the provision of health care across Africa representing a first step in the promotion of a more inclusive and effective training package. Training activities are promoted in the context of “Supporting FBOs on the frontline of healthcare service delivery in Africa”, the program launched by CUAMM in 2019 with the final goal of strengthening the capacity and resilience of staff working in faith-based health facilities through training, technical assistance and advocacy activities. To date, 150 faith-based organizations located in 26 countries, are involved in the program.

A new diagnostic tool in neonatology

Posted on by Redazione Cuamm

There is an important diagnostic tool in neonatology that can be used in babies arriving at the emergency department in critical situations: it is transfontanellar ultrasound, i.e. in babies with an open fontanelle. Specific training was focused on this diagnostic method at the Complexe Hospitalier Universitaire Pédiatrique in Bangui (CHUPB), Central African Republic, to learn and improve its use. Children with convulsions and/or sepsis or with acute malnutrition in order to assess and possibly exclude an underlying neurological pathology, children with macrocrania, and even children with spina bifida or cleft lip and palate, conditions that are frequent in this country: all these young patients will have a new diagnostic tool at their disposal.

“This training has given us the opportunity to review and improve our diagnoses in neonatology by showing us that we can also identify other pathologies beyond those typical of the newborn. As a paediatric oncologist at CHUPB, I will try to apply this expertise to supplement my means of diagnosing brain tumours in infants and children,” said Dr Kosh.

The training was instrumental in demonstrating the potential and versatility of the ultrasound instrument, enabling health professionals to become more proficient in its use. The course is part of the ongoing training plan for staff, including students and residents, on perinatal and paediatric care techniques that Doctors with Africa CUAMM and the Hospital Directorate are promoting as part of the “Support for Paediatric and Nutritional Care, Resilience and Governance at CHUPB” project, funded by the European Union, which started on 1 July 2024. As part of this intervention, CUAMM provides technical assistance and training in the administrative, management and clinical areas, while promoting the strengthening of CHUPB governance. This commitment thus makes it possible to ensure quality health and nutritional care for young patients.

“This course has been a great opportunity, because it has allowed us to broaden our diagnostic capabilities with regard to neurological disorders in infants and children who still have open fontanels. I remember the case of an infant with a rash and convulsions, who was treated and discharged from hospital; a month later, this infant came back with convulsions, without fever but with a pathological electroencephalogram,” says Ida Noki, CUAMM paediatrician at CHUPB. “We treated him with an anti-epileptic and then, thanks to the ultrasound scan, identified a triventricular hydrocephalus and so referred him to neurosurgery. Without this diagnostic tool, the management of this child would certainly have been different, probably inadequate. Now, we have one more possibility to look for lesions early and we have understood how to better monitor cases,” Ida enthuses.

The contents are the sole responsibility of Doctors with Africa CUAMM and do not necessarily reflect the vision of the European Union.

 

FRENCH VERSION 

The training focusing on the newborns needs

Posted on by Redazione Cuamm

A workshop with 20 experts from Doctors with Africa CUAMM, UENPS (Union of European Neonatal and Perinatal Societies), EPS (Ethiopian Pediatric Association), and the Health Ministry of Ethiopia has just concluded in Addis Ababa. This meeting marked the first step in the new intervention aimed at strengthening neonatal care in Ethiopia, all thanks to the support of the Italian government.

“The meeting of these two days was beneficial and fruitful for getting to know and connect with a group of Ethiopian Neonatologists. We were able to plan the main initiatives and the topics to be covered in a first congress that we will organize in January 2025, a starting point to improve neonatal care in Ethiopia,” said Corrado Moretti, director of UENPS.

This endeavor will see CUAMM at the forefront mainly in treatment activities, rehabilitation of some NICU (Neonatal Intensive Care Units), provision of materials and equipment for the wards, and, most importantly, training of health personnel.

“It was an important meeting for all project partners,” emphasized Dr. Eleni Hagos, CUAMM pediatrician at St Luke Hospital in Wolisso. ”We defined the framework and the actions we will implement based on an interesting survey conducted by UENPS in 44 neonatology units in Ethiopia. Once again, we start from the real needs of people and look for ways and answers to improve the care of tiny newborns.”

CUAMM will renovate, improve and equip the neonatology units of Shire Hospital in Tigray and Black Lion Specialized Hospital in Addis. In addition, the project includes training 20 Ethiopian pediatricians through the involvement of neonatologists from UENPS and EPS. The Ethiopian pediatricians, in turn, will train 125 midwives and nurses on neonatal resuscitation. The expected beneficiaries are more than 20,700 women and more than 3,700 newborns treated at the NICU of the two hospitals.

“I returned to Ethiopia after some years away, and I was able to verify that the country has grown in terms of neonatal care,” said Gaetano Azzimonti, CUAMM program manager, on the sidelines of the meeting. We found very competent and motivated people who have clear goals and are committed to achieving them; I am thinking, for example, of CUAMM pediatrician Dr. Eleni, Dr. Atsani, head of Neonatology at Black Lion Hospital, the largest in Ethiopia, and Dr. Bogale, president of EPS. The value of this intervention is in the training of neonatology doctors and the techniques and methodologies to teach them. These specialists will train other health personnel, midwives, and nurses, particularly from Black Lion and Shire Hospital, but in the future also in many different areas of the country.”

This intervention is linked to one presented in Tigray in recent days in the presence of Tigray’s interim president, Getachew Reda, by the Italian ambassador to Ethiopia, Antonio Palese, AICS Addis Ababa director, Isabella Lucaferri, and CUAMM director, Fr Dante Carraro.

Capacitation for neonatal emergencies and stabilization

Posted on by Redazione Cuamm

92 health workers coming from 7 facilities across the country have been trained on neonatal emergencies and stabilization as part of the R.I.S.E. project implemented by Doctors with Africa CUAMM UK. Such project is part of a 46,5 million euro initiative funded by the Italian Agency for Development Cooperation, reaching 900,000+ people affected by the Ukraine crisis.

The trainings were designed in collaboration with the Moldovan Paediatric Association with the ultimate goal of fostering capabilities on emergency neonatal resuscitation and stabilization among local medical staff serving both at primary hospitals and secondary health facilities therefore strenghtening the national health system.

The first phase of the activity started with a 5-days training of trainers held by Dr. Daniele Trevisanuto – Neonatologist and CUAMM doctor and dedicated to 7 professionals from both IMAC Hospital and the Ministry of Health (MoH). By empowering a group of skilled instructors, the activity had a trickle-down effect on a wider network of health workers from 7 facilities disseminated troughout the Country namely Soroca, Orhei, Ungheni, Edinets, Hincesti, Cahul and Causeni thus ensuring a sustainable impact.

«The courses organised have a significant impact on the practice of health workers in district hospitals. Considering the low opportunities they have to practice resuscitation, such activity can indeed support professionals and improve their clinical skills through both theoretical and practical information» claimed Dr. Olga Rotari – Neonatologist from IMAC and ToT.

In Moldova, there are 32 hospitals handling a total of 27,000 births annually. However, many of these facilities have a low number of deliveries per year, below 500, resulting in limited exposure to maternal and newborn emergencies from health workers. Additionally, hospital data reports a high rate of post-birth transfers from peripheral facilities, that are not equipped with intensive care units, to third-level facilities located in the capital. Having qualified staff at peripheral level is therefore of paramount importance to guarantee quality and timely newborns care after delivery.

For this reason, the second phase of the training activity aimed at empowering health professionals serving in second level hospitals with a 2- day training course at each of the 7 hospitals. The methodology embraced both frontal learning, through explanation and powerpoint presentations, and practical experiences. Simple and complex neonatal resuscitation scenarios were staged, where all the participants were requested to apply the techniques explained in a highly stressful situation. The overall 92 participants involved were represented by different professionals including 9 neonatologists, 13 gynaecologists, 8 paediatricians, 34 midwives, 25 nurses and 3 anesthetists who had the opportunity to navigate and practice on multiple concepts and procedures including neonatal resuscitation, neonatal asphyxia, diagnosis and treatment of hypoglycemia and pneumothorax emergency.

«The course was a great opportunity because not only we consolidated some previous knowledge, but also learnt new information. Although we try to assimilate as much as we can during courses, we do not come across situation that requires these skills in our daily practice. Such lack of exercise leads us to loosing confidence and capacities which we regain with these trainings» said Ciobirca Ana – midwife at Hincesti Regional Hospital.

The success of the training is reflected in the significant improvement in the participants’ knowledge, as measured by the test delivered at the very beginning and end of the training. In the pre-test, the participants from the 7 facilities reached an average 60% score, while the post-test showed an accuracy of 93%, with an increase of 33 points percentage.

Maternal mortality rate has significantly decreased in Moldova over the past 10 years, dropping from 44 per 100,000 live births in 2010 to 19 in 2017, the infant mortality rate per 1,000 live births has declined from 26 in 2010 to 12 in 2019 thanks to the proactive commitment of the Ministry of health and health workers. However, this rate still remains above the WHO index for European regions. Although maternal and infant mortality rates have reduced over the years, there is a margin to improve the mortality index and the output of emergency procedures by working on the remaining gaps regarding referral and post-natal healthcare in peripheral hospitals.

Since the conflict broke out on 24th February, 2022, approximately over one million refugees crossed the border seeking refuge in Moldova, one of Europe’s most fragile countries. To prevent the collapse of the national healthcare system and address the healthcare needs of both the refugee and local populations, targeted interventions have been deemed necessary. CUAMM’s commitment in the country started in April 2022 in the capital Chişinau. Since then and in close collaboration with the Ministry of Health and the WHO, the intervention has been guided by the twofold objective of providing basic medical assistance within RACs and offering specific training for local medical personnel on neonatal emergency. The commitment also extends to Ukraine, focusing on the delivery of medicines, medical equipment, and consumables to healthcare facilities; distribution of food items, essential goods, and equipment to combat the cold; as well as providing psychological support to the most vulnerable. Our project, is part of a 46,5 million euro initiative funded by the Italian Agency for Development Cooperation, reaching 900,000+ people affected by the Ukraine crisis.