*Y.C.* Safe motherhood troops.
My idea is going to be built on the foundation of an established national program called the national youth service corps(NYSC). NYSC is a prerequisite for every undergraduate of a polytechnic or university upon graduation;for medical personnel upon the completion of your compulsory one year internship. It is a year in which you are randomly posted to serve in any country of the federation, and in many rural areas is almost the only source of health personnel and teachers.
This program presently sends out 3 batches (every 3 months) of qualified, young, and ambitious young doctors like me to far regions of the country with limited resources, and very few trained medical personnel to cover sometimes more than one local government as a medical officer. Most of these areas are populated by semi-literate,economically disadvantaged populations whose main occupation is farming, or fishing. My idea is to maximize the skill if the doctors posted to such areas, to provide free antenatal care to every pregnant female in such areas. As the pilot batch for this idea which i hope to start in as I commence my service year on the 9th of March 2009 in Anambra state,my plans are to:
make one day every two weeks a day when i provide free antenatal care for pregnant women in the local government where i am sent to.
Before it commences,I plan to meet with the community elders, and indigent medical staff who are usually, community health extension workers or officers, and nurses, to tell them about the alarmingly high maternal mortality rates in our community,and to find out what they think are the causes. Thereafter, I will educate them what the most commonly documented causes are, the eventual problems which maternal mortality cause to families and the community and how these are avoidable if every pregnancy is monitored by trained health personnel for its duration. Thereafter I will introduce my proposed plan to them which is as follows:
That fortnightly on a set aside day which we would have decided, we hold a health education seminar in the mornings from 8am-10am for every pregnant female and female of reproductive age group who can attend. Thereafter we will do free urinary pregnancy tests for women who feel they are pregnant, and if positive,register them for antenatal care.
Every woman who attends the health seminar at least once a month(at which we will educate them on the importance of antenatal care, delivery by a skilled birth attendant, nutrition in pregnancy, answer questions on myths in pregnancy, teach them the danger signs in pregnancy, and advice them on family planning and contraceptive use, and HIV in pregnancy by singing local songs,telling stories, role acting in their own language)will be eligible for free hematinics- iron, folic acid, and vitamin c tablets, free intermittent preventive therapy for malaria and a capillary pcv check and blood sugar test every two months for the duration of their pregnancy.
We will also in case of miscarriages, or inevitable abortions provide post abortal care and will train only nurses and doctors in the health centers to do this. Manual vaccuum aspiration kits will be provided in every health center for this purpose.
Emergency cases which are identified will be referred to the closest available tertiary center for management of the pregnancy.
At my planning session with community leaders and indigent health workforce, I would have inquired on who regularly attends to women in labour and also plan to involve them and the indigent healthcare workers in this initiative. A week of pre-training prior to the start of the program on what we will be teaching the indigent women, and also on how to take blood pressures and pulse rates, and the significantly dangerous values, take capillary pcv's, estimate duration of pregnancy and delivery dates, palpate for fetuses, and what can indicate an imminently difficult delivery and where to refer such cases to.
In addition to this a key part of my initiative will be to generate accurate local data from the start of the project on the number of women in reproductive age, causes of maternal mortality, average age of first delivery, numbers of children born, contraceptive awareness and need are just a few very important data variables that this initiative will generate.
To improve the rates of deliveries assisted by trained personnel, i will propose to the community leaders and the local government that every woman delivered either at our health facility or who makes use of a certified trained nurse or traditional birth attendant should have their child registered, given a birth certificate, and that the baby and mother are eligible for free monthly checkups and full vaccination for the first year of the baby's life(but will have to buy medications at subsidized rates for the child and full rates for the mother in case of illness).
My plan is to introduce this concept to my colleagues in other states of Nigeria to carry out a project along the same lines and for us to evaluate the communities response to this program. Most of the materials we will need as relatively inexpensive and i plan to write to the large pharmaceuticals- Glaxosmithkline and Fidson to provide us with free hematinics tablets for our test run. We will ask the community and local government to procure about 3 Manual sphygnomanometers for each facility, and numerous tape measures and plastic fetal stethoscopes for the antenatal clinics. We will also ask the local government to procure one manual centrifuge as many of these communities do not have a steady supply of electricity and some do not have at all. After the pilot set of doctors with whom i have already shared my plan, we will create a manual to outline what will happen at each antenatal visit based on the estimated gestational age and how the program will be run. From each set of doctors working at the time on any project, some will be chosen to go to the orientation camps of incoming doctors to recruit willing personnel and subsequently train them for 2-3 days on how to run the program, fill in the data questionnaires and collate data which each outgoing set will submit to the ministry of health of the state government. Every doctor who serves in this capacity for the duration of their service year will be given an additional letter of recommendation by the Minister for health, and will also receive a small financial stipend every 3 months apart from my pilot set as an incentive for the work.
I plan by thus doing to provide very importantly the right kind of information to the community on pregnancy, its importance and on how it can be rightly manged using affordable resources we can procure or already have. I also plan to ensure that maternal mortality rates fall to their barest minimum by duplicating this effort and ensuring its continuity in every rural local government in Nigeria. this will also improve maternal health greatly, increase contraceptive awareness and use, and very importantly generate vital data that we can use to reform our methods and make objective health financing and policy decisions in our communities.
About You
Section 1: About You
First Name
Onikepe
Last Name
Owolabi
Website
Organization
Country
Are you an individual between the ages of 18 and 35 who would like to apply for a nine month Young Champions Program mentored by an Ashoka Fellow?
Yes
Section 2: About Your Organization
Organization Name
Organization Website
Organization Phone
Organization Address
Organization Country
The information you provide here will be used to fill in any parts of your profile that have been left blank, such as interests, organization information, and website. No contact information will be made public. Please uncheck here if you do not want this to happen..
Your idea
Name Your Project
*Y.C.* Safe motherhood troops.
Country your work focuses on
Nigeria, AN
Describe Your Idea
My idea is going to be built on the foundation of an established national program called the national youth service corps(NYSC). NYSC is a prerequisite for every undergraduate of a polytechnic or university upon graduation;for medical personnel upon the completion of your compulsory one year internship. It is a year in which you are randomly posted to serve in any country of the federation, and in many rural areas is almost the only source of health personnel and teachers.
This program presently sends out 3 batches (every 3 months) of qualified, young, and ambitious young doctors like me to far regions of the country with limited resources, and very few trained medical personnel to cover sometimes more than one local government as a medical officer. Most of these areas are populated by semi-literate,economically disadvantaged populations whose main occupation is farming, or fishing. My idea is to maximize the skill if the doctors posted to such areas, to provide free antenatal care to every pregnant female in such areas. As the pilot batch for this idea which i hope to start in as I commence my service year on the 9th of March 2009 in Anambra state,my plans are to:
make one day every two weeks a day when i provide free antenatal care for pregnant women in the local government where i am sent to.
Before it commences,I plan to meet with the community elders, and indigent medical staff who are usually, community health extension workers or officers, and nurses, to tell them about the alarmingly high maternal mortality rates in our community,and to find out what they think are the causes. Thereafter, I will educate them what the most commonly documented causes are, the eventual problems which maternal mortality cause to families and the community and how these are avoidable if every pregnancy is monitored by trained health personnel for its duration. Thereafter I will introduce my proposed plan to them which is as follows:
That fortnightly on a set aside day which we would have decided, we hold a health education seminar in the mornings from 8am-10am for every pregnant female and female of reproductive age group who can attend. Thereafter we will do free urinary pregnancy tests for women who feel they are pregnant, and if positive,register them for antenatal care.
Every woman who attends the health seminar at least once a month(at which we will educate them on the importance of antenatal care, delivery by a skilled birth attendant, nutrition in pregnancy, answer questions on myths in pregnancy, teach them the danger signs in pregnancy, and advice them on family planning and contraceptive use, and HIV in pregnancy by singing local songs,telling stories, role acting in their own language)will be eligible for free hematinics- iron, folic acid, and vitamin c tablets, free intermittent preventive therapy for malaria and a capillary pcv check and blood sugar test every two months for the duration of their pregnancy.
We will also in case of miscarriages, or inevitable abortions provide post abortal care and will train only nurses and doctors in the health centers to do this. Manual vaccuum aspiration kits will be provided in every health center for this purpose.
Emergency cases which are identified will be referred to the closest available tertiary center for management of the pregnancy.
At my planning session with community leaders and indigent health workforce, I would have inquired on who regularly attends to women in labour and also plan to involve them and the indigent healthcare workers in this initiative. A week of pre-training prior to the start of the program on what we will be teaching the indigent women, and also on how to take blood pressures and pulse rates, and the significantly dangerous values, take capillary pcv's, estimate duration of pregnancy and delivery dates, palpate for fetuses, and what can indicate an imminently difficult delivery and where to refer such cases to.
In addition to this a key part of my initiative will be to generate accurate local data from the start of the project on the number of women in reproductive age, causes of maternal mortality, average age of first delivery, numbers of children born, contraceptive awareness and need are just a few very important data variables that this initiative will generate.
To improve the rates of deliveries assisted by trained personnel, i will propose to the community leaders and the local government that every woman delivered either at our health facility or who makes use of a certified trained nurse or traditional birth attendant should have their child registered, given a birth certificate, and that the baby and mother are eligible for free monthly checkups and full vaccination for the first year of the baby's life(but will have to buy medications at subsidized rates for the child and full rates for the mother in case of illness).
My plan is to introduce this concept to my colleagues in other states of Nigeria to carry out a project along the same lines and for us to evaluate the communities response to this program. Most of the materials we will need as relatively inexpensive and i plan to write to the large pharmaceuticals- Glaxosmithkline and Fidson to provide us with free hematinics tablets for our test run. We will ask the community and local government to procure about 3 Manual sphygnomanometers for each facility, and numerous tape measures and plastic fetal stethoscopes for the antenatal clinics. We will also ask the local government to procure one manual centrifuge as many of these communities do not have a steady supply of electricity and some do not have at all. After the pilot set of doctors with whom i have already shared my plan, we will create a manual to outline what will happen at each antenatal visit based on the estimated gestational age and how the program will be run. From each set of doctors working at the time on any project, some will be chosen to go to the orientation camps of incoming doctors to recruit willing personnel and subsequently train them for 2-3 days on how to run the program, fill in the data questionnaires and collate data which each outgoing set will submit to the ministry of health of the state government. Every doctor who serves in this capacity for the duration of their service year will be given an additional letter of recommendation by the Minister for health, and will also receive a small financial stipend every 3 months apart from my pilot set as an incentive for the work.
I plan by thus doing to provide very importantly the right kind of information to the community on pregnancy, its importance and on how it can be rightly manged using affordable resources we can procure or already have. I also plan to ensure that maternal mortality rates fall to their barest minimum by duplicating this effort and ensuring its continuity in every rural local government in Nigeria. this will also improve maternal health greatly, increase contraceptive awareness and use, and very importantly generate vital data that we can use to reform our methods and make objective health financing and policy decisions in our communities.
Website URL
Innovation
What makes your idea unique?
My idea is unique in that it is incorporated into an existent Government initiative ensuring that there will always be personnel to provide the service in areas with a need for this kind of service where normally people do not willingly go to work. Many doctors, due to abject lack of resources, become frustrated during their service year, however this idea maximizes the available and inexpensive resources which even the doctor will have to provide necessary and effective care to a significant part of the population. My idea aims to bring together policy makers, local stakeholders, and healthcare professionals as each will play their part and derive considerable results from its implementation a rare feat to achieve in my environment.
In addition, it is one sure way to ensure that indigent health staff receive some form of health training providing not just a much needed service but ensuring its continuity by teaching resident locals the objectives and need for this initiative and how to sustain it on their own. It also proffers the answer to the relatively unanswered question of how to generate accurate population data of Nigerian rural areas, whilst offering the community the incentive of free healthcare for the first year of every child life to motivate mothers to register the birth of their children and thus help planning for the future.
It also through the health education seminars, provides a means for the individual women to ask their unanswered questions and for us to address questions on cultural issues, reaffirming the advantageous aspects and advising caution on unfounded myths.
My idea if properly carried out has the potential, to rebirth the much needed place of primary health care in our health system, to raise the health standards of my country, and to see us achieve what are seemingly impossible development goals.
Do you have a patent for this idea?
Impact
This Entry is about (Issues)
What impact have you had?
My project is still in the idea phase as thus we are yet to have any measurable effect. We however hope to see all of our goals as stated in the idea realized and to even find more ways of making the project beneficial to my country.
Problem
Approximately 150 words left (1200 characters).
Actions
Approximately 150 words left (1200 characters).
Results
Approximately 150 words left (1200 characters).
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
First year: in its first year, what my project needs is the cooperation of the local government and the community leaders in the areas where the initiative is to be carried out. This is essential for us to have access to our target population and the relatively inexpensive tool we will need to carry out the antenatal care. We will also need to have relatively skilled indigent health workers to increase the workforce, and reduce the length of time and cost of training.We also need to have at least a 100 women participate in the initiative to have a relevant data sample to study and compare to non-participatory indigenes.We also need a ready local supply of the medications we listed.
In the second year, we have to be able to convince the state government to incorporate this fully into the NYSC program based on the success of the pilot project. We also need to build up training manuals for the next set of doctors, and for new indigent health workers, to ensure an acceptable and continuous standard of care. We will also need to acquire a manual centrifuge and to incorporate the free health care for babies and their mothers delivered by trained skilled birth attendants.
By the third year, we will have to expand our project to other villages in each state where it starts off to increase our impact, generate more publicity and thus more interested personnel and funding for the project. We will also need to have an independent monitoring and evaluation team audit the initiative to ensure that the integrity of the project and the participants are maintained
What would prevent your project from being a success?
Our project might not be a success if it's incorporation into the NYSC scheme is not approved after the pilot project even if it does well.
It must be accepted in the pilot stage by the local governments, and community leaders to mobilize the indigenes, and the resources we need to start it off.
It would cease to be a success if for any reason we cannot provide free hematinics, and intermittent preventive therapy for malaria as the least form of medication, and if any of the participating staff start to use resources for personal monetary gain.
Our project would also not be a success if we do not provide in addition to the antenatal care the one year free monthly consultation for every mother and baby delivered by our trained personnel.
How many people will your project serve annually?
101‐1000
What is the average monthly household income in your target community, in US Dollars?
Less than $50
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Idea phase
Is your organization a
Please select
Is your initiative connected to an established organization?
If yes, provide organization name.
How long has this organization been operating?
Please select
Does your organization have a Board of Directors or an Advisory Board?
Does your organization have a non-monetary partnerships with NGOs?
Does your organization have a non-monetary partnerships with businesses?
Does your organization have a non-monetary partnerships with government?
Please tell us more about how these partnerships are critical to the success of your innovation.
Approximately 150 words left (1200 characters).
What are the three most important actions needed to grow your initiative or organization?
Approximately 300 words left (2400 characters).
The Story
What was the defining moment that you led to this innovation?
I did my last rotation in my medical internship year in obstetrics and gynecology, and was privileged to work with 2 consultants who were completely passionate about their work and patients. Even as a house officer, many of us are jaded about the failing health sector and quality of medical practice even in our tertiary institutions.Meanwhile here were two people (one internationally trained) who were working with what we considered small and old fashioned to produce excellent results. Our patient load was almost double that of some other units in the same specialty, and our morbidity and mortality rates were at an all time low. Even our poorest pregnant patients, were progressing well on the cheapest available medications by strict compliance and with the regular antenatal visits, i saw semi-literate to illiterate patients able to talk confidently on their gravid conditions.Those with hypertension and diabetes,knew about their conditions and what their delivery options were, and many of those i saw delivered referred patients with similar conditions as a result of simple explanations provided at health education sessions and by my senior colleagues.Waiting expectantly for my NYSC posting, i had already started to think: how could i have this same kind of impact where i was posted. I did hope to be posted to a city with better options for a job and pay, but as soon as i learnt of my location i told myself- This is your chance to make a large difference with all the little things you've learned. I spent the next 2 days trying to draw up a structure for how to build up a system in my head, and called up a few friends with a passion for public health who had been posted to other eastern states of the country. We agreed to think it through separately and do a collaborative project, and then i'm running through my email when 2 friends who do not know each other email me the Ashoka fellows link. It feels like serendipity at work, and the fire in my heart is fanned into writing my thoughts down and seeing them become real, and so my idea was born.
Tell us about the social innovator behind this idea.
I'm 25 years old multi talented young doctor, who just completed my medical internship.I'm passionate about helping people, particularly socially, educationally and financially handicapped people, and i love the field of Public health. I'm particularly interested in epidemiology with excellent mathematical abilities, but i also love to read all kind of literature, i love classical music/jazz, and i'm crazy about international cuisine.
I enjoy travelling and as thus have travelled on many health outreach projects with the organization i volunteer for, where i am at my best multitasking between being a doctor, a logistics officer and doing anything else that needs to be done. I enjoy working with young people, seeing them realize their dreams, and helping them give back to the society by various means, and have been opportuned to volunteer extensively with a couple of campus based youth oriented organizations. I do calligraphy, taking up as many free-lance jobs as possible both for the mere pleasure of writing and for the extra money it brings. I am a stock market novice, very interested in the financial world and have been managing my own portfolio for a few years.I come from a family with 3 female children, and a mother who was a doctor, and i am an advocate for the proper education care and provision of equal opportunities for every female child around me.I look forward to undergoing further training as an epidemiologist by going for my masters in public health, and a Ph.D in epidemiology and my major career goal is to build effective health research systems in Africa to ensure improved standards of health care,policy and strategy in Africa revolutionizing health standards and the practice of medicine. I am always excited to be connected with groups of people who are improving the standards of life in their communities anywhere in the world, and i am very open to innovative and sustainable ways of producing results in any field of life. I completely believe in the ability of anyone to accomplish anything they dream of if they invest their whole being in it, and I look up to Martin Luther king junior and Mother Theresa of Calcutta as popular examples of what you can do if you believe in it.
How did you first hear about Changemakers?
Web Search (e.g., Google or Yahoo)
If through another, please provide the name of the organization or company
- Login to post new content in this forum.
Comments
Onikepe,
I think it is wonderful that you have idetified an existing program, a mandatory internship program, as a delivery mechanism to provide marginalized communities with increased access to health care. Have you thought more about how to get local, state, and national government to support this initiative? Do you think that other interns going through mandatory internships would have a similar attitude as you in using their expertise to help underserved areas? For those who might not share your enthusiasm, do you have ideas to provide incentives to motivate them to work with their communities? What are your ideas to ensure that the model set up is sustainable after the intern departs? Thank you for your entry! I think it is a great example of taking an existing program and maximizing its impact!
Dear Jessica. Many interns in my country's national youth service actually start out with high hopes about the one year although there are also fears of living in new environments, how to make money, and missing family. We have an initial 3 week orientation camp to introduce us to the program. A few intiatives such as a unicef in conjunction with some other bodies, organize a peer health education training on hiv/AIDS and adolescent reproductive health, there is also a road safety training, and most recently a training on millenium development goals. People are encouraged to implement the skills learned during that one year, but from one on one contact with my peers, many do not. only a few can sustain their initial enthusiasm, there is really no incentive to continue except those who see the advantage in the certificate awarded and that one year for us is usually a year where if you cannot get a well paying job, you while away your time shuttling between the place of you internship posting and home.
However there is huge potential in the population available to implement this program:young capable people who if given the right push can change their communities. th eabove programs may have the limitations i mentioned, because the entire target community is not really involved in the implementation, and so they aren't made to feel like stakeholders in the events of the year, however, i plan to apart from getting the permission of the state and local government meet with a cross section of the community, market women's association heads, the traditional rulers, the priests of the local parish, the heads of families, some nominees of the women themselves, and indigent health staff to involve them in the planning for the years program. We will tell them thet advantages, and how we need their input to affect their lives. We plan for them to act as our recruiters for every woman in the village to attend those critical health talks where we will establish our trust based relationship and encourage them to come for antenatal care.
For the doctors and othe rinterning health staff we will be using, the fact that there is a laid down plan for the year will serve as an encourage ment to get involved as usually the internship year is boring in a ruural area with limited activities, and very poor health seeking behaviour of the population so that you usually have few patients.
With this program, we plan to make the forthnightly health talks an event to look forward to. the doctor gets to coordinate the training of staff, the planning of the days events, and all the staff and women prepare the health education songs in their language, rehearse the role plays so that they want their family to come and see them "in action". The village leaders will be involved in opening the days events, and we expect that as the mothers and children come, it will improve the health seeking behaviour of their husbands the men in the long run.
With a ready population of patients, the doctors will get to practice their medical skill and very often will have to teach simple things to the local staff, a rush for any new doctor, and as is common in our culture without saying clients are often appreciative of their doctor's relationship and will often bring foodstuffs of various kind just to say thank you for being there.
As i said in my introduction to my idea, a new set of interns come in every 4 months, and so every present intern will have someone new to initiate into the scheme, show the prepared protocols, introduce to the village, and pass on what they have learned to. If the community is involved in the planning and implementation, and eventually start to enjoy the benefits of safer births, good antenatal care, access to free medication, and the presence of skilled health care providers, they will be willing to sustain the scheme, and encourage their local leaders to provide accomodation for new interns and will be receptive to them as they understand the importance of the service they provide.
I also plan that the state government should provide an additional stipend for financial renumeration every trimester an intern spends there, to encourage them and that they should recieve additional recommendation at the end of their internship year. Also as we plan to collect much needed statistical data, we are going to be helping not just the state government have accurate documentation of demographical statistics, but the federal government to plan in their budgeting for every state in which the project is carried out. We will also be helping to rebuild the place of primary healthcare and to encourage young interns who are healthworkers that working in rural areas can be fulfilling and can be paid for reducing the internal brain drain from our rural to urban areas.
thank you very much for you comment although it took me quite while to respond.It did help me look at other ways in which my idea can benefit all the parties involved and how it can keep running. This internship program has immense potential to change not just the face of antenatal care and improve maternal health but to raise health standards in my country. I believe it will, we just need to start from somewhere.
Post new comment