Outreach
WNF also operates Outreach projects; the Maternal Outreach Project (MOP) and the Community Outreach Project (COP).
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Maternal Outreach Program (MOP)
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The Maternal Outreach Project (MOP) aims at providing maternal health services to pregnant women in remote, rural areas/villages around Masanga hospital by weekly outreach interventions.
A pilotproject of Masanga Hospital in 2020 revealed that most maternal complications and deaths happened to high-risk pregnant women who attempted delivery outside a hospital. A complex of social economic factors (personal barriers, poor infrastructure, unawareness of risks at birth giving) contributes to these worrisome outcomes.
The current MOP interventions are focused on conducting ultrasound scanning examinations in Community Health Centers (CHC's), located in 45 small villages. Authorized professionals scan the women, diagnose the pregnancy and register the outcome in a computer system.
If a high-risk pregnancy is identified (e.g. twins or placenta previa) the woman gets a thorough medical consultation conducted by the MOP scanning team. A referral letter is handed out with clear advice to give birth at the nearest hospital. In case of emergency, the woman is referred to the national ambulance service (NEMS) of Sierra Leone.
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Sponsored students involved
WNF started this project to offer maternal health services and family planning consultation to the communities in small villages in hard-to-reach, rural areas in Sierra Leone. At the same time, it created an opportunity for the students, who WNSF sponsors, to operate as certified scanners in the maternal outreach interventions. They gain a wealth of work experience in rendering obstetrics services in the field.
Research
In order to evaluate the outreach interventions, a quality research project has been started. The research aims to assess broadly the influence of the program on pregnant women in rural villages.
The research team evaluates the interventions for better understanding of:
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The effect of the interventions on facility birth
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How and why women make decisions around child birth
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zooms in on the separate unique group of adolescent preganacies
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The cost effectiveness of the operations.
This will hopefully ensure that future interventions are meaningful and affordable. A reduction of the Maternal Mortality Rate (MMR) is hardly measurable. The MOP program can only identify the pregnant women that carry a high risk and encourage them to go to the nearest hospital for facility birth. If properly managed, the program has everything in it to save lives and limit maternal risks.
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Community Outreach Program (COP)
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The Community Outreach Project (COP) includes two different services:
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Family planning
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Child health
The project originally focussed on providing care to people in the very small villages around Masnaga hospital. However, this wide range of services was too complicated to perform, dealing with all kind of issues related to individual cases. Therefore it was decided to structure the activities to only two main areas of attention: Family Planning and Child Health. And the community outreach activities are more and more integrated with the maternity outreach activities in the same villgages.
The concept of the Community Outreach Project (COP) is to provide a one-year training program to a number of local health care workers and let them do the actual work in the field of Family Planning and Child Health.
Family Planning
The purpose is to give women more control of the number of children and the intervals between the births. Under the supervision of a Community Officer, so-called Family Agents (FA's) provide information regarding birth control and contraceptives. As women and their partners usually lack trust to uptake the contraceptives, the role of the FA’s is to create awareness and build trust among the people in the community. The distribution of contraceptives is done by Masanga hospital.
Child Health
The purpose of this service is to educate parents about taking care of the hygiëne and health of their children. Primary goal is to make sure that all children are vaccinated and that prevention takes place of severe sickness and malnutrition. This is done by so-called Child Agents (CA's) who regularly screen the children for vaccinations, diseases and malnutrition.
Sustainability
A main element of COP is to focus on sustainability. If the project is to create sustainable changes in the villages, it is necessary that from the very beginning an “exit” strategy has been defined. The supervision of the COP Community Officer should be replaced by the local Community Health Centers (CHC’s). For this to happen fixed arrangements have been made to transfer the responsibility for the health talks and child health issues to the people of the CHC’s.