Despite recent progress in reducing poverty, Uganda remains one of the poorest countries in the world with 38% of the population living on less than $1.25 per day. Out of a population of 39 million, 85% of people live in rural areas.
Every year, 5,400 women die due to pregnancy-related complications. A woman living in Uganda is 80 times more likely to die giving birth than if she were living in a high-income country. Infection, post-partum haemorrhage and preeclampsia/eclampsia are major contributing causes of death. While over 90% of women attend an antenatal clinic at least once during the pregnancy, fewer than half receive skilled care at delivery. Geographical inaccessibility and lack of transport pose major challenges. Even when women are able to access a health facility, they may find that life-saving care is not available. Clinics and hospitals often lack essential medicines and supplies. Without significant improvements in access to quality maternal healthcare, Uganda is not expected to achieve the MDG-5 targets by 2015, or even by 2025.
The ProFam social franchise network, developed by PACE and supported by MSD for Mothers, aims to tackle some of these problems. The overall goals of the programme are to complement the government’s efforts to reduce maternal mortality by strengthening the access to and quality of maternal care provided through the private health sector, and increasing the demand for and utilisation of quality health care services by expanding community level outreach. PACE seeks to achieve these goals first, by expanding the number of ProFam clinics and the scope of their services to family planning and a range of maternal health services (e.g. antenatal care, delivery, postpartum care, family planning), and second, by expanding community-level outreach through Mama Ambassadors, an association of community health workers. The franchise currently operates in 43 districts across Uganda.