Femi and Meghan from the BOLD team were in Uganda and Nigeria in April to meet with the country teams and visit potential BOLD study sites. The ideal health facility for inclusion in the BOLD project will have
- a high volume of births (more than 200 births per month)
- an obstetrician on staff
- labour monitoring procedures and
- prior engagement in research activities
Having these characteristics will help to ensure that the data collected for BOLD activities (SELMA and Passport to Safer Birth) is high quality and reliable.
At each facility, we met with the hospital administration and an obstetrician, but spent most of our time with the midwives. The midwives walked us through the antenatal/postnatal wards and the labour and delivery rooms as they talked us through the process that women go through from arrival at the facility to hospital discharge. In particular, we discussed labour monitoring procedures and challenges that they face in their work.
In Uganda, Dr. Kidza Mugerwa (the Ugandan Principal Investigator) facilitated our visit to three hospitals of varying size and structure that were within a two hour drive of Kampala. In Nigeria, Dr. Bukola Fawole (the Nigerian Principal Investigator) met us in Abuja, where we visited three district hospitals that were quite similar in terms of structure, capacity, and procedures.
One of the main challenges that the midwives discussed was the significant population of women who arrive at the facility in advanced stages of labor and with complications. These women often were not booked and accounted for the majority of maternal deaths and severe maternal morbidities. Next, we set off to Lagos, where we visited one facility (which happened to be the facility where Femi was born!). Finally, we drove out to Ibadan to visit another health facility and the University of Ibadan.
Femi made a second trip to Uganda in May to assess another set of hospitals. He met with hospital staff at potential BOLD study sites to discuss the BOLD projects and how they could participate.
Overall, we found that health workers of all cadres were making the most out of the available resources in order to provide the best care possible. There was palpable enthusiasm among hospital staff to participate in the BOLD project and we look forward to collaborating with such a passionate team!