Centering Uganda

May 5, 2016

By, Dr. Andres Rodriguez, OBGYN Resident at MUSC

Week two has proven to be equally as busy in the operating theater as my first week. But my main focus and dedication has been on establishing the Centering program here at the Masindi Kitara Medical Center (MKMC).  To better understand what antenatal care and management in Uganda means, I spent two days working with Sister Doreen (the primary provider of outpatient antenatal care).

In short, here are a few stark differences I learned about:

  1. Women often don’t come in for their first visit until 14-26 weeks gestation (nearly all first visits are done in the second trimester).
  2. An average number of visits during the prenatal period is 4 (5-6 would be extensive care) as compared to 8-10 visits in the States.
  3. There are no dating ultrasounds or confirmatory tests for gestational age.
  4. Visit dates consist of a visit in each trimester (if possible) and a final visit to discuss delivery.
  5. Interestingly, all mothers who come to clinic are given a brief educational session by Sister Doreen before each one is taken individually for their respective meetings (a similarity that should benefit the establishment of formal antenatal care).

So, with all of this being said, this week I created an adapted form of the patient manual from CenteringPregnancy and spent 40 painstaking hours with Jimmy (great guy who knows 4-5 languages) translating what I had written into Runyoro (the local language here in Masindi).  We have sent it off to be printed locally and have also contacted some 13 women (10 were interested and committed) in regards to our first Centering meeting next week.

I also gave a brief CME regarding group prenatal care and the potential benefits, and I conducted a mock-Centering meeting as a method of training with some of our very enthusiastic nurses and midwives, which went very well. The team of midwives and nurses have been absolutely fantastic and jumped right on board with what we are trying to do.

Overall, a very good week.  Looking forward to next week’s meetings and whatever else comes through the OR. If you want to learn more about participating in a rotation as a medical student or resident please contact our Director of Volunteers.

Dr. Andres Rodriguez is an OBGYN Resident at MUSC. He served with OneWorld Health at the Masindi Kitara Medical Center for one month. In addition to working with our midwives and Dr. Godson, he is working to determine the feasibility of a group antenatal care model at MKMC, based on Centering programs in the US. He previously came with one of our quarterly medical teams in 2010.

Photo by Joshua Drake Photography for OneWorld Health

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