Hospital Leadership Training Saves a Mother and Child
After five hours of labor, Rachael Kabugho was in excruciating pain. The staff at Bwera Hospital in western Uganda examined her but they lacked the clinical skills to determine why the birth wasn’t progressing. Meanwhile, Kabugho was getting weaker and her pain was becoming worse. Fears were growing that the 29-year-old mother of three and her baby would not survive
One of the top priorities for Uganda’s Ministry of Health is reducing the nation’s high maternal mortality rate. Out of 100,000 live births, 336 mothers died in 2016. Decentralization of health services in Uganda have exposed the need for strong leadership among governments and health facilities at the local level and their ability to provide quality care to patients. With appropriate management skills, health professionals can take ownership over their role in the health system and help to make these systems more sustainable.
Fortunately for Kabugho, the Bwera staff quickly transferred her to Kagando Hospital, where the head nurses had been trained in clinical and leadership skills through the Leadership Development Program Plus (LDP+). MSH implemented this program, which aims to train health care managers so that they can lead their work groups to face challenges and achieve results. The goal is to create a work environment that motivates staff at all levels of the health care system so they are committed to continuously improving client services.
Health care managers and their staff at Kagando Hospital first identified obstacles and priority areas to tackle high maternal mortality and then implemented actions to improve services for pregnant women such as: providing family planning services through community outreach sessions, conducting discussion groups with male partners about benefits of family planning, ordering supplies before stocks run low, and training village health teams to provide information about family planning, HIV testing and other health topics.
Within a year of adopting LDP+, Kagando Hospital saw impressive results among its 35-member team. Team members had institutionalized monthly planning and review meetings, developed their service and management skills and improved their ability to capture and use data through on-the job training. Maternal deaths fell from an average of four a month to one or less because of increased efficiency and early referrals from the community.
The training enabled staff to quickly assess Kabugho and determine that the baby was malpositioned, making a vaginal delivery both difficult and dangerous. Staff then promptly opted for cesarean delivery, saving Kabugho and her new daughter, Bira.
Once afflicted by poor emergency care services, a high maternal mortality rate, and few trained staff, the hospital's service delivery has steadily improved since the implementation of the LDP+, say hospital staff.
Before training, providers were not working together and could not identify solutions to the many problems at the hospital. Esther Atolere, Principal Nursing Officer said, “After the trainings, all this changed. Kagando Hospital now has a committed team with the capacity to solve any challenges that hinder service delivery or access to health care. Our patients are now satisfied with our services.”