Untold journey while I served

Ilaleit Lindah Ruth is my name aged 32 years. A midwife by profession working with Mbale district local government in eastern region of Uganda.

In a line of duty, I started working with Mbale district local government at Jewa health centre III from 2018. It was a hard to reach area with a Muslim affiliated background and presence. The landscape details features of difficult terrain making it uncomparable in the end. The natives had different norms and customs bearing it in mind hard to sensitise them on the new born servant! "Jhpiego", it tendered in the family planning and other services of the modern age!.

On my assumption, my presence seemed a posture without meaning, I lived in the strange community without notice, days, months and years passed to unwaivering days and barren hand at service.

"Yes, I see the un bothered mothers with knowledge but without child spacing!" I recalled how my profession would turn a planned society with meaningful children by child spacing, healthy and ignited mothers in marriage without depression. 

My supervisor seemingly never realised the zeal of my calling, I asked for his opinion and the feedback wasn't my last resort. The conscience reminded me of gaps that I had observed amidst such risky mothers.

At this level, I was naive and felt sorry for shaking my head in disbelief, indeed several mothers had severe complications and UTIs eating them up in that complex  community without interventions. It prompted me to encourage mothers to visit healthcare sessions.

The momentum started building whereas husbands complained of misfits among spouses? Numirantinfections had been caused because of multiple partners.

In the same environment, it looked evident: adulteration was a subject between the young and elderly. It was never going to be a belittling agenda to adopt the new sequence in family planning, the efforts seemed not aging but my inner heart went beyond my thoughts!. I went relating possible dangers to mothers and asked them to attend antenatal services and follow these lessons. As for me, this could resize or cause family planning  indictment positive.

Myths and denouncements came to pass, family planning was clearly heard. Husbands were never calling it home, the dark days had blindfolded it all...! One day a mother stood firm and narrated the disbelief citing poised talk about family planning.

It was the beginning of the new servant in the waiting "Ask me about family planning" Jhpiego stated. The lines in the age started as real education about family planning resonated to stay!

The community began to appreciate the efforts while we went through retooling by Jhpiego. Mothers pegged at the facility for routine consultations on family planning and infection free living, it didn't turn simple on me, it was now collective efforts in the facility since teamwork coupled with specialisation while the information flow indicated treatment responses.

The maternity wards became full and cues lines were interrupted daily by other services at the facility. This was the  genesis of family planning intervals to mothers who had realised the positivity in its offing.

The family planning methods got underway and in the long run, this picked pace as most mothers demanded short term methods with a handful going for long-term jabs. This lightened the community to remain resilient and taste suspense until the assurance developed among those that had attained particular services.

The dark days vanished after Jhpiego stood outside with resilience among trusted clients.

The afterbirth had a lot of foldings because the dark days had been candled by the Jhpiego family.

One-day I opened the platform and my name was among the chosen one for the TCI jhpiego training in Lukhobo hall During the training all of us were asked about TCI but not all of us knew, we were then taken through TCI U and ODK installed in our phones and  was awarded a certificate in TCI.

I was able to attend another training at school of clinical officer mbale on IPPFP (IUDs) and practicum in Mbale regional referral hospital and namatala. 

Onsight orientation was conducted to all facilities whereby all healthworkers including support staffs were trained on family planning i.e from the gate to a mortuary through jhpiego.

Through TCI jhpiego Family planning integration was done at all serving points i.e ANC,PNC,ART,LAB,OPD,YCC and it became business unusual these mother's could access services at any time and anywhere including hotspots but before it wasn't integrated.

TCI with conjunction with Sr. Adong and Sr. Juliet,DHO, ADHO distributed logistics i.e manuals, Aprons, Tshirts  that motivated us.  It also helped me capture more clients including couples and they took up methods of choice as a couple and we're so appreciative for the good services rendered to the community as numbers also improved greatly from zero to a hundred plus.

There was good turn ups of mother's  during inreaches and outreaches with the help of VHTS who were so committed to their work in mobilising the community and sending reports for community efforts.

TCI woke me up on how to fill the column for postpartum timing, integration and effectiveness of a client after in the register before I used to think PPFP goes up to six months but it goes up to one year. Through TCI integration most the community got answers to the myths and misconceptions which was rectified.

TCI trained me as amaster coach after a training in Tororo classic hotel I went to another level and became a mentor. Thanks to TCI.

   I received a couple with two wives who used to compete to bear children in jewa there's a belief that when deliver ababy aman has to take good care of the wife especially financially that you will never lack anything but this man wished all the wives to join family planning but the second wife refused thinking the man can marry another woman. One-day the man came to me and said musawo advise your friend to join Family planning lam tired of having children every year even icant satisfy the children's needs but he said if she refused lam ready to divorce her and she gets another man isaid go slow iwill talk to her because at first she had told me the man doesn't want yet she had just formulated so after continueous counselling she was willing to comeback unfortunately I was transferred but followed up with colleagues she consented. 

  TCI also trained me on how to win couples to allow their women to join IPPFP.

I also gained more knowledge and skills in proving IPPFP especially  IUDs interval IUD using Kelly's forcept.

 Through TCI it also made me admired by fellow staffs especially when you go for mentorships they were so inquisitive to know how I reached to that level. 

  There was integration into ANC services through PPFP  Counselling.

  Provision of group education on PPFP during ANC sessions.

  Male involvement in ANC and the few were told to pass the information to the community during their meetings i.e at drinking points, bars etc.

 Proper documentation of IPPFP choices in the client cards or ANC cards and even in the ANC register column for Family planning was to be filled with a method of choice.

  Strengthening linkages between ANC and delivery points whereby FP methods were distributed in laboursuit and all serving points. 

Improve on attitude, practices of ANC providers to support PPFP.

  Improve on workplans after mentorships.

     During delivery strengthening of skilled birth attendants/ VHTs to provide PPFP methods.

 Equip maternity FP services to offer PPFP.

  I mprove on Exclusive breastfeeding counselling to all discharged mother's and attend PNC at six days and six weeks.

  I really appreciate Jhpiego because it has taught me a lot of things bit knowledge and skills ican insert IUD very well before ididn't know I was familiar with Implants and shortterm and most staffs benefitted with knowledge and skills my husband too knows about TCI Jhpiego@Sr. Adong. when it comes to family planning he is a champion  🏆 🏆 so supportive. 

  However I encountered some challenges. Lack of some equipments for interval IUD Kelly's forcept. 

 Limited space and no privacy when providing FP services. 

  Lack of a sterilizer for sterilizing  instruments.

   Denial by other healthworkers even if you mentor them severally they report you to supervisors badly. 

   Poor turn up of colleague when called for CMEs at facility level.

    Delayed payments after conducting activities.

     Poor transport and infrastructure especially during rainyseasons.

   Delayed reports in ODK due to poor network systems.

   Lack of interest by few health workers they perceive that we get a lot of money in jhpiego especially when you go for mentorships.

Submitted by 

Ilaleit Lindah Ruth 

Enrolled Midwife/ Master coach TCI Jhpiego.