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 UgandaNonbranded 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 birthsXX
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 expensesUse 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 complicationsXX
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.