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Uganda Innovates

Heard about bike ambulances? They are reducing maternal mortality rates in rural Uganda

 

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Bike ambulance driver Grace Kakyo transports a patient in northern Uganda. Photo Credit CA Bikes

Here is how a well executed fast and simple plan is managing to reverse the trends of maternal health care system in Uganda. From going to remote areas and helping pregnant women, the Bike Ambulances are improving lives of pregnant women in many villages in Uganda with high maternal mortality rates, leading to a healthier future.

Before 2015, health and community workers in hard to reach areas in Uganda lived in a dilemma. They had to trek to impenetrable villages trying to save expectant mothers lives. Most roads were not friendly to cars and they had one solution- carrying the pregnant women on their backs or on homemade stretchers. To cut the long story short, many did not make it to hospital. They died on the way.

Fast forward to 2015 and now, a light is beaming bright at the end of the maternal health care system tunnel in Uganda. Bike ambulances are the reason. The reason why many pregnant women in rural Uganda are now singing to the glory of a simple, fast and cost effective way they are reached in, in remote areas.

Bike ambulances are unstoppable. On the dusty and muddy roads in remote areas whether Uganda or in any other low developing country, two wheels are better (and reliable) than four. Where a vehicle ambulance may take two hours to reach, a bike ambulance can take thirty minutes.

In some areas, you find that an expectant mother has to travel over 30 kilometers to reach a health center where they have to deliver and out of say 70% of expectant mothers who go for antenatal care I, only 20% go back to deliver meaning there are so many who remain back home and  delivery is done by Traditional Birth Attendants (TBA) which number you can’t tell and that’s why bike ambulances are reversing this trend vigorously.

The bike ambulances idea is a simple one. They are two-wheeled ambulance trailers that can be easily connected to virtually any bicycle or motorcycle. When a patient needs to be moved, the Village Ambulances offer a safe alternative to the precarious boda-boda (motorcycle) ride that would traditionally be used to transport many Ugandans, or worse, being left at home to suffer rather than seeking the help the patient needs.

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The motorbikes have gone to over 10,000 callouts in four years. Photo credit: ITV

They are here to reverse trends indeed. According to the 2011 Uganda Demographic Health Survey, Uganda’s maternal mortality rate was found to be 438 per 100,000 live births.  

On the other hand, the MDG 2014 report by the United Nations Economic Commission for Africa together with the African Union, African Development Bank Group and the United Nations Development Programme on assessing progress in Africa toward the MDGs, to date 95% of Ugandan women receive antenatal care from a skilled provider at least once, 57% deliver babies in a health facility under the supervision of a skilled provider. Furthermore, 33% of the mothers received a postnatal checkup within two days of birth.

The new emerging statistics by the United Nations Economic Commission only shows one thing, that there are positive strides in achieving zero maternal deaths which directly and indirectly, can be attributed to bike ambulances.

This innovative idea however, was invented by Chris Ategeka, a graduate of Engineering from the University of California who returned back to Uganda in 2013 to help contribute to the reduction of Maternal death in Uganda and founded Rides For Lives.

Ategeka founded Rides For Lives, a nonprofit that invests in training local healthcare professionals so as to create a sustainable workforce and manufacture locally sourced medical vehicles with the mission of improving medical access and economic opportunities to those that are the most vulnerable.

In an interview with NPR, Ategeka and Ride For Lives stated that they have managed to support the fabrication of the bike ambulances  at centralized workshops in local villages which has led to the distribution of more than 1,000 bikes and bike ambulances throughout Uganda.

Only 100 bike ambulances can transport about 10,000 expectant mothers a month. Put another way, this is 100 lives saved every year after deploying just one of their ambulances to a district each year. With over 200 Village Ambulances distributed in over 23 districts across Uganda it doesn’t take a mathematician to work out that this equates to over 5,000 lives saved every year thanks to their innovation.

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Bike ambulances are loved because they are fast, affordable and can reach remote areas. Photo credit: Kissito Health

 

However, the question remains, how are young mothers getting access to these bike ambulances and how can we have more of these?

Many young mothers continue not having access to antenatal care services in different parts of the country. Still, a big number of them do not have information about the existence of bike ambulances to help significantly reverse this trend.

This is where district leaders and civil society must come in to advocate for increased funding and awareness of the innovative idea. This idea, can be transformed then into greater heights and before we know it, it will be a major turning point in the history of maternal mortality rates in Uganda.

Simon Otiga, The Vice Chairperson of Soroti District while at the launch of the ambulances in the district on January 27, 2015, urged the beneficiaries to use them so as to boast the maternal health care system of the district and reduce on the maternal deaths.

The Speaker of the ninth Parliament Rt. Hon. Rebecca Kadaga while launching the ambulances last year at parliament, encouraged MPs to advocate for more bike ambulances to be distributed to all villages in Uganda so as to reduce on the maternal mortality rates.

Initiatives like these and others being implemented players in the health sector like the Voices For Health partners for example FOWODEReproductive Health Uganda, Reach A Hand, Uganda and UHMG to mention but a few, could help in saving lives of many young mothers all over the country who continue to die because of failing to get access to fast, cost effective and reliable services. That is when we will achieve a big step towards reducing maternal deaths in Uganda.

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Uganda Innovates

Athieno Mary Lucinda is changing girls’ lives one sanitary pad at a time

She stood up in class, her classmates laughed at her. The boys said that she had slaughtered a chicken. They made fun of her for a long time. She couldn’t afford sanitary towels, the anxiety of the monthly period coupled with the embarrassment she had faced which would have destroyed her self-esteem as a young girl instead stirred her resolve.

Meet Athieno Mary Lucinda a YALI fellow, the founder of Eco-Pads a social enterprise dedicated to the production and distribution of reusable pads and environmentally friendly to girls in Uganda.

“That experience kept me wondering what I would ever do to save a girl the embarrassment I had gone through. While at university, I went to volunteer with Kadama Widows Association where I am the Executive Director now and as I interacted with the girls, they had similar challenges. I then started saving part of my stipend to make the pads and that was my aha moment.” Lucinda says.

The sanitary pads are distributed to young women in rural Uganda. These Eco-pads are Menstrual Kits that are made from very high performance fabric and provide comfort and supper protection for a period up to 12 months.

“The Eco-pads project started in 2008 as a local thing trying to just help girls in the community. In 2014 we realized we can improve on quality and start selling for sustainability and we have been growing daily from just the local community to many parts of the country with over 20 full time  and 35 part time employees.”

“I am most proud of last year when we reached 50,000 girls with Eco-Pads, the feedback from the girls attending school daily is heart-filling. The involvement of parents and the whole community in the cause is great. We have reached over 75,000 community members on Menstruation being an issue and how they support. Mentored over 10,000 girls” Lucinda says.

There are challenges that are still to be overcome. Being a local product, Lucinda’s biggest challenge has been in marketing and getting the product to be known, convincing the clients that it is a good product since it is new. The very first money that they used was grant money that they used to buy equipment and set up and buy some few materials.

Despite the challenges, she has mentors that encourage her when things are going down hill. my “Atuki Turner the ED of Mifumi, Tracey the founder of glad rags U.S, Mary Mosinghi the ED of KwaAfrica. They remaind me that I need to remain a learner and humble in whatever I do.”

At the heart of this project is the desire by Eco pads that every girl child remains in school. Eco-pads give affordable sanitary pads for girls, because many miss out of school during their menstruation. They are competing against appalling statistics 80% of Girls in Uganda are absent from school during their periods. 70% of female students reported difficulty of attending class attentively due to menstrual related problems. 90% of the poor women and girls do not use (off-the-shelf) sanitary pads, but instead improvise with unsanitary materials. Prior to their first period only 51% of girls had knowledge of menstruation and its management

“We educate girls on MHM, conduct mentorship sessions and educate the parents and teachers on the need to support girl child. We shall continue to do something regardless of the tide. One sanitary pad at a time.” Lucinda says

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Uganda Innovates

This Ugandan Startup is making low cost sanitary pads out of sugarcane!

It all started when Lydia Asiimwe Sabiiti the Founder of EcoSmart Pads, met a 16 year old girl Kyomuhendo who had travelled a long way, hailing from her village in Rwanyamahenbe, the Western part of Uganda.

Kyomuhendo was being escorted by her mother in search for better health care at Mbarara Regional referral Hospital. She had developed wounds in her vagina that had first presented with itching soon after her menstruation period.

“As I approached her, I could tell she was in so much pain. Her eyes were swollen from crying and her mother seemed weary from managing her daughter’s pain. They couldn’t find their way through the hospital so I offered to walk with them to the department of Obstetrics.” Lydia explains.

As the two walked and talked, Lydia learnt that due to failure to afford sanitary pads, Kyomuhendo had been using 3 pieces of the same old cloth over the last 2 years of managing her menstrual flow. She learnt that the same cloth was shared among 3 of her sisters and 2 other cousins who all lived with them.

Her mother mentioned with distress that the cloth had not only changed color over time but had also developed a very bad odor making it increasingly uncomfortable to wear at school or any other public place.

“I silently concluded that this form of menstrual management was the source of Kyomuhendo’s pain and I was determined to do something about it. I facilitated the CAMTech Uganda internship programme and I got my chance to tell this story to ateam of students who had enrolled for the programme.” Lydia explains.

When Lydia finally told her story, three other students on the programme were inspired to act and they joined her and together, they formed a team. The team grew to be known as the EcoSmart Pads team and they have figured out a way to upcycle sugarcane fiber into a material that they are now using to make low cost and eco friendly sanitary pads that people like Kyomuhendo will be able to afford. Their vision- To ensure equality, vibrancy and dignity in menstrual management among girls and women in Uganda.

Lydia conducting an awareness session

The Eco-Smart Pads idea

The Eco Smart Pads are sanitary pads made out of sugarcane recycled residues for girls and women of menstrual going age from low income backgrounds.

“Sugarcane residues at sugar manufacturing factories are the raw materials to our product and are obtained at an affordable price.” Lydia says. She is convinced that this idea will work because of the low costs of production that will significantly lower the price of this product.

The team first conducted an experiment in the Microbiology lab at Mbarara University of Science and Technology to determine which one of the two between Maize and Sugarcane had residues with a high absorbance rate. Sugar cane emerged with a higher absorbance percentage and was selected as the plant to be considered as a raw material for this innovation.

“We did conduct a needs assessment, interacted with our end users and generated findings from them, informing our price estimates and product packaging quantities.” Lydia explains.

Right now, EcoSmart pads team is sending on the market a 12 piece pack (because the end users said on average each would be conformable to use 12 pieces in a single menstruation period).

“We are selling each pack at UGX 1500 cutting down current costs by 50%, 90% of the end users we interacted with said they could only afford to pay between ugx 1000 – 1500. We are not looking to generate much revenue from sales because we are selling to low income earners. We are looking to work with philanthropists to cause impact in our local community. As for the sustainability of our company, we are looking at other income generating options.” Lydia elaborates.

These pads are also disposable. The team figured you don’t give a reusable pad to uneducated- rural based -low income earners and expect them to maintain it at its required high standard hygiene levels. They will maintain it the same way they maintain the old cloth that they use – washing it at night and keeping it wet under their beddings. It will cause infections and the problem will not have been solved. The EcoSmart sanitary pad is disposable and our packaged quantities allow them to change the used pad at least 3 times a day which is more healthy.

The primary beneficiaries of this product are school going girls from low income backgrounds whose pursue of education has been affected by this challenge.

Other non school going women from low income backgrounds such as women in prison, refugee camps, public hospitals, are also primary beneficiaries of this product. Generally, female Ugandans from high income earning backgrounds will too benefit from the low cost of this product as they will be able to make some saving.

In June 2017, EcoSmart Pad team won a $10,000 grant from UNFPA’s UpAccelerate program to move the idea from inception to prototype development.

The issue of menstruation

Menstruation is one thing which almost every woman has to deal with. Every month.

Many Ugandan women still use scrap cloth from old saris and towels, the traditional method for managing menstruation for thousands of years.

On average, a single woman generates 125kg of sanitary waste during her menstruating years when she uses disposable sanitary products.

A UNESCO report estimates that one in ten girls in Sub-Saharan Africa misses school during their menstrual cycle. By some estimates, this equals as much as twenty percent of a given school year.

Many girls drop out of school altogether once they begin menstruating. Young women miss twenty percent of school days in a given year due to a lack of facilities or a lack of information or a lack of sanitary products.

In june 2017, EcoSmart Pads told their story during UNFPA’s Up Accelerate challenge and the judges were touched. They won a $10,000 to move our idea from inception to prototype development.

Don’t you think Eco Smart Pads is going to change this status quo?

Like this story? Or have something to share? Write to us: info@thisisuganda.org, or connect with us on Facebook and Twitter.

 

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How Ensibuuko is building Life Changing ICT-Mobile solutions for the under-served Rural Poor

Almost four years ago when youth unemployment was at its peak and everyone was clamoring for a steady job, Gerald Otim decided to walk into the world of self employment. Having had a humble beginning, he was no stranger to starting small and therefore he ventured into the building a solution that would improve financial service delivery in rural communities.

In 2014, Gerald a Fin-Tech Entrepreneur and a graduate of Development Economics at Makerere University together with David Opio, co-founded Ensibuuko, a Ugandan ICT startup that is modernizing the way financial cooperatives (popularly known as SACCOS – Savings and Credit Cooperatives) manage data and deliver financial services.

“We are providing modern electronic banking infrastructure to financial services entities unique to the developing world. Our main service is a cloud-based banking software platform for micro-finances and SACCOS. The platform automates business processes, customer and transactional data, and provides standard accounting and reporting functionality for Ensibuuko’s customers.” Gerald explains.

Ensibuuko’s software is a cloud-based MOBIS Micro-Finance Software first designed at the Kampala based ICT hub, Outbox and is creating a solution that allows for web services even in rural areas with poor telecom infrastructure thereby contributing significantly to the efforts for financial inclusion in Uganda and across Africa.

The Start Up’s software is also integrated to the mobile phone network allowing users to access their account via mobile phone — they can check the balance, make deposits and withdraw. This improves access and quality of service delivery.

“Our solution is integrated with Mobile Money thus people in hard-to-reach places can be part of the easy access of the service. We are now using partnerships with mobile Network Operators to deliver a dedicated internet bundle that enables institutions access the solution on cloud even on weak networks for just 30,000 shillings a month ($8).” Gerald notes.

The platform therefore exists to equalize financial services in Uganda as is the case in many other African countries where banks are urban based. People in rural communities will be served mainly by a cooperative institution.

According to Ensibuuko, there are major issues in the financial services sector in the developing world: Banks are concentrated in major towns, Services are expensive and loans have interest rates of not less than 24%. It is part of the general problem of poor and expensive financial services infrastructure in all of the developing world. Instead of working with banks, most people will prefer a non-bank financial institution mostly in the nature of a Cooperative financial institution such as a Savings and Credit Cooperative (SACCOS) or Credit Union.

Through Ensibuuko, Gerald has created a platform that is bringing financial services to the developing world.

“These institutions usually have no access to modern infrastructure and they rely a lot on human resources for their operations as they continue rudimentary means to manage financial information and make decisions.” Gerald notes.

To date, Ensibuuko’s business volume is 151 SACCOS reached in 2 years. Of these, 14 are newly signed, 35 are active on the Mobis platform and 102 are on their current pipeline in Uganda. There are over 14 other institutions in 3 other African markets that are currently in business with Ensibuuko through its recently established  franchises in Zambia and Tanzania. Ensibuuko has raised 1 Million USD in funding (500,000 of which came through a recent Equity investment deal) and maybe the first ever ICT startup with Ugandan only founders to raise this much funding within its first two years of existence.

Inefficiency, human error, fraudulent tendencies have become typical of these institutions and is undermining their role in delivering financial services to the under-served. In Uganda there are over 6000 registered SACCOS serving 18 million people. It is estimated that there are over 300,000 of such institutions in Africa. By using technology to strengthen financial institutions, Ensibuuko has the potential to significantly disrupt the rural financial services sector not just in Uganda but across Africa.

Like this story or have something to share? Write to us: info@thisisuganda.org, or connect with us on Facebook and Twitter.

 

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