SMGL Interventions Implemented During Phase 1 and Scaled Up During Phase 2 to Reduce the 3 Delays in Northern Uganda
| SMGL Interventions (Phase I) | SMGL Intervention Scaled Up to Phase 2 of Northern Uganda | Nonbranded SMGL Scale-Up (in Northern Uganda) |
|---|---|---|
| Increase awareness and seeking care for safe delivery to reduce the first delay | √ | √ |
| Training of village health teams to encourage birth preparedness and increase demand for facility-based delivery care | √ | √ |
| Community outreach activities to counsel women, families, local leaders, and community organizations | √ | √ |
| Distribution of mama kits to incentivize facility-based births | X | X |
| Community mobilization messages (e.g., radio, billboards, and newspaper articles) and drama skits | √ | √ |
| Promotion of demand- and supply-side financial incentives to facilitate women seeking, accessing, and using quality care services (e.g., transport and delivery care vouchers, user-fee reductions, and conditional cash transfers) | Use of saving groups to save for birth expenses | Use of saving groups to save for birth expenses |
| Increase access to quality health care services to reduce the second delay | √ | √ |
| Upgrade a sufficient number of public and private facilities with appropriate geographical positioning to provide—24 hours a day/7 days a week—clean and safe basic delivery services | √ | √ |
| Ensure that a minimum of 5 EmONC facilities are providing the recommended lifesaving obstetric interventions 24 hours a day/7 days a week | √ | √ |
| Hire a sufficient number of skilled birth attendants to consistently provide quality, respectful basic delivery care, diagnosis, and stabilization of complications | X | X |
| Create a consultative, protocol-driven, quality-assured, and integrated communication/transportation referral system available 24 hours a day/7 days a week that ensures women with complications reach emergency services within 2 hours | √ | √ |
| Improve quality, appropriate, and respectful care to reduce the third delay | √ | √ |
| Train health professionals in emergency obstetric care, including obstetric surgeries | √ | √ |
| Ensure mentoring of newly hired personnel and supportive supervision | √ | √ |
| Strengthen supply chains for essential supplies and medicines | √ | √ |
| Ensure implementation of quality effective interventions to prevent and treat obstetric complications | √ | √ |
| Introduce sound managerial practices utilizing “short-loop” data feedback and response, to ensure reliable delivery of quality essential and emergency maternal and newborn care | √ | √ |
| Strengthen maternal mortality surveillance in communities and facilities, including timely, no-fault medical death reviews performed in follow-up to every institutional maternal death with cause of death information used for ongoing monitoring and quality improvement | √ | √ |
| Promote a government-owned health management information system that accurately records every birth, obstetric and newborn complication and treatment provided, and birth outcome at public and private facilities in the district | √ | √ |
Abbreviations: EmONC, emergency obstetric and newborn care; SMGL, Saving Mothers, Giving Life.
√, SMGL interventions were implemented.
X, SMGL interventions were not implemented.