HEALTH WORKER TALES: How a mentorship visit rebirthed the newborn unit at Buluba Hospital
Paul Plesk writes in his article Recognising the importance of innovation in health service delivery that “if we continue to do what we’ve always done, we will get the results we have always gotten. Nor is it enough to merely pursue incremental improvement. The challenges we face today call for more novel approaches-in other words, innovation!”
What Plesk observes is synonymous with many healthcare settings in many a developing country contexts including Uganda where there is a lot of resignation to the state of affairs and creativity is hardly forthcoming to enable the use existing resources. However, as innovation winds of change continue to steadily blow in parts of the country and if the momentum is maintained, a revolution in healthcare delivery might just be underway in some hospitals.
In our latest Health Worker Tales Series, Kakaire Ayub Kirunda relates the story of how a mentor attached to the Preterm Birth Initiative (PTBi) Study recently caused a revolution in newborn care at St Francis Hospital Buluba in Mayuge District, where they were having challenges with caring for vulnerable little citizens.
Ms Damalie Mwogererwa (in picture speaking to midwives) who is a specialised neonatal nurse attached to Mulago National Referral Hospital has a habit. Whenever she visits any hospital, she is curious to find out the state of neonatal care and this is what exactly happened on her first outing as a clinical and quality improvement mentor at Buluba under the PTBi study. Damalie shares her experience in the following anecdote:
“I was showed a room full of cots for infants. A nurse told me it was far from the maternity ward. That they couldn’t keep moving back and forth because they were few in number. But I told her I have been to places where nurses thought they were few but at the same time able to care for both neonates and mothers.
We embarked on rearranging the place. I asked them whether they had an incubator. They told me they were down and not working. I said let’s look at them. When we tested the two wooden incubators, they were all functional. They were only dusty and condemned but they were in good condition. Before we finished cleaning, a preterm was at hand, waiting to enter. We put this preterm in the incubator after cleaning and setting it up. Baby came in with a slightly low temperature, but before we left, temperature was within the normal ranges.
On the subsequent mentorship visit, we found a nurse in the unit taking care of three babies and to my surprise they had even got a new incubator. It was not in use. They were saying they did not know how to use it, but it had a manual on top. We just read the manual and everybody got used to the incubator and before I left, a fourth one was in the new incubator.
Initially, they were referring every preterm born at the hospital. They did not believe this could work out. They now tell me their babies are surviving and the team is feeling good.”
The Buluba and Damalie’s experience is yet another manifestation that as low and middle income countries wait for adequate human resources and infrastructure, through creativity and innovation coupled with attitude change, marked improvements in service delivery can be registered working with available resources.