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prosami. A program for the promotion of maternal and infantile health in rural areas. Acronym is derived from the French title: Promotion de la santé maternelle et infantile. Kasai oriental province (DRC). Approximately 168126 km ² . Two majors Semi-rural cities: - Mbujimayi
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prosami A program for the promotion of maternal and infantile health in rural areas. Acronym is derived from the French title: Promotion de la santé maternelle et infantile.
Kasai oriental province (DRC) • Approximately 168126 km². • Two majors Semi-rural cities: - Mbujimayi - Mwene-Ditu • Rural villages: remote, separated, lack of infrastructure, lack of health care facilities.
Population vs. available health care facilities • Population: approximately 8.235.257(density: 50 Hab/km²) • Population in age of reproduction estimated at: 1.600.000 • 5 District Hospitals. • 750 health care centers providing maternal and infantile health.
Rural community problems • Illiteracy, ignorance, hazardous beliefs and practices. • Little income (> 1$ per capita): Poverty and deprivation. Pandemic state of malnutrition. • Environmental hazards: lack of basic infrastructure (water, electricity, sanitary ablutions…)
Health care system in villages • Virtually no existent in some areas. Community depends on distant neighborhood. • No communication system (road, transport, telephone…). • Safety issues. • No health care workers. (Use of family members, traditional birth attendants, untrained personnel).
Infantile health in the province of Kasai Oriental • Neonatal mortality rate: 48/1000. • there was a total of 133.824 neonatal deaths in 2008. (MINI SANTE 2008). • National progress toward MDG 4: average annual rate of reduction less than 1.0 per cent (the state of the world’s children 2008. Unicef).
Maternal health, mortality and morbidity. • National maternal mortality rate: >550 = very high (source interagency group: WHO, Unicef, UNFPA, World Bank. 2005) • Causes: post partum septicemia, post partum hemorrhage, prolonged labor, anemia & malnutrition, malaria, diabetes, hypertension (essential and pregnancy induced), cardiac, tetanus, STD’s & AIDS, unexplained death of mother or child. • Unreliable Data reporting.
South African perspective • to bring antenatal care to the community. • Creation of mobile clinics. • Midwives obstetric units. (MOU) • Advanced midwifery training. • National reduction in maternal and infantile mortality and morbidity rate.
Advanced midwifery concept • Comprehensive course designed to improve the health of mothers and neonates of the rural community. • Encompasses general and specific management of the mother from preconception to include administration, training, research. • Cost effective where there is shortage of medical doctors. Utilizes competent midwives.
Objectives • To promote maternal and infantile health in the rural areas by improving the quality of perinatale care through: - an appropriate training of health care providers, defining the standard of care applicable to the rural context. - the creation and establishment of health centers in geographically accessible areas to the population to be served.
Plan of action. • Establish a pilot center. • Define the standard of care. • Train health care staff. • Establish rural health care centers • Monitor care delivery • Provide continuous in-service training • Collect statistiques • Advocate for rural community • Act as regulatory body • Apply sanctions
Implementation phase 1 • Establish the pilot center comprising: - maternal & child health care center. - training center. - stock warehouse. - construction department.
Phase 1 cont. • Training professors in advanced midwifery. - Candidates selection criteria. - The training college. - The cost. - Timing.
Implementation phase 2 • Training at the pilot center - objective. - candidates selection criteria. - training sessions. - the cost.
phase 2 cont. • Establishment of rural health care centers. - designating the area. - the building. - provision of health care. - Medications and supplies.
Administration. • Project director. • Vice-director. • Administrator. • Secretary. • Warehouse manager. • Financial specialist. • Training coordinator.
Board of directors • USA section: Congo section: - President - Vice-president. Vice-president - Secretary. Secretary - Treasurer. Financial specialist - legal counsel legal counsel - logistics logistic - education coordinator. - Registered agent - Accountant