About MAMA

Our Mission

Educate women and empower midwives to increase skilled birth attendance and health facility delivery.

We are a midwifery-centred maternal health charity, working in Uganda, registered in the UK in 2017. Our primary objective is to improve the availability and quality of healthcare for expectant mothers and their babies, in Hoima and Kikuube districts, Bunyoro sub-region, Uganda.

Skilled birth attendance and delivery in a health facility reduce the risks of harm to both mother and baby. The World Health Organization (WHO) concludes that skilled attendance during childbirth is “the single most important factor in preventing maternal deaths”. We target the three delays described as contributing to adverse outcomes in pregnancy and childbirth: the woman, and her family’s, decision to seek care; economic and physical accessibility of care; and the quality of the care available once accessed (Thaddeus, S. et al. (1994)). We aim to enhance access to quality healthcare, skilled medical staff, medical resources and comprehensive referral services, thereby increasing skilled birth attendance and health facility delivery, so decreasing serious pregnancy complications. This closely aligns with the United Nations’ Sustainable Development Goals, as well as priorities from the WHO, Ugandan government and the Hoima District Development Plan.

Maternal health in Uganda lags behind both national and international targets, and is negatively impacted by marked poverty levels; geographical inaccessibility; lack of transport; and gender inequality. Despite a 50% improvement since 1990, Uganda’s maternal mortality ratio (MMR, maternal deaths per 100,000 live births) is estimated to be 375; approximately 50 times higher than in the UK (The World Bank, 2017).

Our Goals

Comprehensive health education of women and their families;
Improve physical and economic access to skilled birth attendance and health facility delivery, through outreach antenatal clinics and establishment of remote maternity facilities, together with provision of reliable emergency transportation;
Provide safe, high quality maternal healthcare at our facilities, achieved through education of midwives, clinical officers, doctors and health support workers, coupled with reliable supply of resources;
Ensure sustainability of our maternal healthcare services through close collaboration with our Ugandan colleagues.

Our Values

Place women and their families at the centre of our focus;
Empower and promote advocacy of the local Ugandan midwives;
Work with our Ugandan colleagues to establish locally run and led sustainable maternal healthcare facilities;
Remunerate local staff and suppliers fairly, in line with local rates, to ensure retention of well trained, committed staff as well as sustainability of our services.

Where we work

We work in three main locations in Hoima and Kikuube Districts, Bunyoro sub-region, Western Uganda: Hoima town, Runga village and Kyarushesha village. Previously we have held outreach antenatal clinics in other locations such as Nkondo, Tonya and Akiiki.

In Bunyoro sub-region where we work the percentage of births that took place in a health facility (57%) and/or were assisted by a skilled provider (58%) were the second-lowest in 2016 (Uganda Bureau of Statistics). During the financial year 2019/20, Hoima Regional Referral Hospital had both the second highest maternal mortality ratio (611) and rate of fresh stillbirths per 1000 births (37) amongst the regional referral hospitals (consistent with previous years); and in Hoima district 51 maternal deaths were reported (second highest) (Ministry of Health, Uganda). These data highlight the critical importance of our work in the particular area in which we are based.

Hoima

Hoima is the municipal town in the Western Region of Uganda, three hours’ drive North West of the capital city, Kampala. The MAMA Trustees first became involved in healthcare in Hoima town through the regional referral hospital (HRRH or ‘Boma’) and then developed a relationship with Azur Health Centre IV, with whom we still work closely.

Runga

MAMA’s first maternity clinic was established in Runga in February 2017, after running regular outreach antenatal clinics there since 2012. Runga is a small fishing village on the shore of Lake Albert, bordering the Democratic Republic of Congo. The clinic’s monthly running costs are funded through regular personal donations to MAMA, and the Shalimar Trust.

Kyarushesha

In 2017 MAMA expanded to provide an outreach clinic in Kyarushesha, another rural village in Hoima District. In March 2020 we opened our second permanent rural maternity clinic here, thanks to a 2-year grant from UK Aid Direct.

Photo gallery

Click on any image to scroll through the photographs.

When we arrive in any village for outreach we either ask someone to go mobilise the women to come to clinic (tell the women there is a clinic being held) or we walk through the town ourselves. We usually draw a bit of a crowd, especially with the children

Health talks are provided before each Outreach Clinic to gain ethics and consent of testing and awareness of keeping well and safe in pregnancy as well as covering topics like malaria prevention and domestic violence

Local midwife, Harriet, joined us at our outreach clinic in Kabwoya. Here she is helping Grace book the new mothers arriving. Women seen here will most probably deliver in her Health Centre

Babies sporting colourful knitwear generously supplied to MAMA by different craft groups around the UK

Public transportation on way up from Runga

The way to Tonya's Maternity Outreach Clinic

Traditional boats line the shore, they are used for fishing in Uganda, usually man powered but sometimes with an outboard motor

Vehicles are often overloaded, then become stranded when they break down

Simon the Builder in Tonya. Simon oversaw the refurbishment of the health centre in Tonya and he also built our Volunteer’s house in Hoima

Children smile as they pump water at Tonya's water pump

Little girl copies mummy carrying her doll on her back

MAMA receives a thank you gift - a small goat

View of the front of Hoima Maternity Waiting Home

Contraception or Family Planning is key to reproductive health

Older children enjoying the knitted toys too

With the arrival of Viola the new midwife the government has made the clinic a Health Centre III.

Some children from Runga Village were outside of the hut where we used to conduct the outreach clinic

Mothers carry their delivery equipment wrapped in fabric on their heads. In there will be the basics for delivery a baby gloves, cotton wool, gauze, drugs, blade and covera or plastic sheet

Grace and Justine the local traditional birth attendant grab some lunch in Runga

This is the church in Runga where we held our outreach clinic every eight weeks before we opened our Maternity Clinic

Fresh beans cooked with tomato, onion and maybe a green pepper are delicious, especially when Josephine or Grace cooks them for you

The Crested Crane is the national bird of Uganda and features on the flag

Runga - the women carry up the rift valley cliff all the fish in the morning and then come down with wood, Uganda

Hoima Lots of fruit and veg available at the local markets. Families will grow a lot of their produce and sell the excess either at the markets or on the roadside

Relaxing on the roof top with Fred our driver after a busy outreach clinic, waiting to start the journey home

Coal production under the mountain shadow

Inquisitive children at the outreach clinics!

Children will help with daily chores including collecting water from the nearest water pump. Bicyles, which are often to big for them, can be used to transport the full jerry cans on foot

Having fun after a torrential downpour, flooding roads and playing fields.

Some of the towns have taps rather than pumps for their water. We pay a small fee when we used this tap to fill our jerry cans for outreach.