Thriving teen moms

In Uganda, 25% of teenage girls are already mothers or pregnant by the time they turn 18 years. These figures are worse off in rural communities where Youth Empowerment Trust Uganda (YETU) operates. Teen mothers lack appropriate maternal and child health knowledge, this is further compromised by stigmatisation and discrimination which comes with being a mother at a young age. YETU will work with community health extension workers (CHEWS)  and use USSD to offer teen moms home based heath education, antenatal, postnatal and immunisation services. These will be supported to birth their babies at YETU Health Centre or at other health facilities. This will result into increased health knowledge, vaccine uptake and the number of teenage births assisted by a skilled health personnel and contribute to reduced maternal and infant mortality among the target population.

In Uganda, 25% of adolescent girls are mothers or pregnant by the time they turn 18 years. These statistics are worse off in rural communities where YETU operates.Pregnancy and childbirth are the leading causes of death among adolescents in SSA. Teen especially girls often drop out of school and miss out on the basic sexual reproductive health education. The life of teen moms is characterised by limited or no maternal health education, stigmatisation, discrimination, forced/early marriage, harmful cultural norms, unplanned/unwanted pregnancy among others. This is further worsened by economic constraints like transport to access health facilities. These challenges trickle down to the babies born of teen girls.

YETU will empower and educate community health extension workers to educate, dispel myths and offer health care that is antenatal care, postnatal care and immunisation services to teen moms. Teen moms will also be supported to birth at YETU health centre or with support of a skilled health care. The solution will also employ USSD to send messages about maternal and child health to mothers regularly and offer question and answer information for the wider public. The intervention will increase evidence based knowledge about health , access to quality, affordable and available among teen mothers and contribute to the number of babies of teen moms who are full immunised.

48.47% of the Uganda's population is aged 0-14 while 21% is aged 15 to 24. Over 300,000 teenage girls get pregnant annually majority of whom live in rural communities. Since its inception in late 2019, YETU Health Centre has served over 70 teen mothers with ,maternity and immunisation services. YETU works with one community health extension worker who is responsible for offering home based care. Based on her findings and interactions with teenagers especially teen mothers, there is a strong desire to take ownership of their lives, and more about their reproductive health and the health of their babies.

A quarter of all Uganda's teenage girls are pregnant or have their first baby by 18. 50% of all teenage girls are married. Their life is characterised by limited or no access to health care, failure to follow routine immunisation for their babies, lack of family panning knowledge and resources etc. Teen moms also lack the economic resources to afford quality health care. YETU will  empower and utilise community health extension workers to provide home based care to teen moms by dispelling myths and expanding evidence based knowledge on maternal and child health.  

There several programs which target improve the health of moms and babies like the Uganda National Expanded Programme on Immunisation which targets women of child bearing age. However; teen moms experience the most stigma as they try to access quality health care from themselves and their babies. First YETU will deliver education and services to teen moms at household level through the use of USSD and in-person meetings with community health extensoon workers thereby eliminating stigma and geographical barriers to access. Second, community health extension workers will combine trusted, traditional networks with modern evidence based health care practices and individualised health care. By working within traditional networks, CHEWs will provide culturally appropriate information which will reduce stigma, discrimination and thus improve maternal and newborn health outcomes.

The community health extension worker uses USSD messaging to follow up YETU clientele with mass messages, reminders etc. The clientele also use this USSD to access health information. It doesn't need an internet connection or smart phone. This will be scaled up to all beneficiaries and the wider community. On the other hand YETU uses kobo collect to collect, save and analyse all information from her clientele. The app is installed on all staff phones. We hope to purchase and use clinic master a system popularly used in Uganda to manage health facilities.

In Uganda, all telecom companies use USSD to communicate to clients especially because access to internet is still very low. By end of 2018 all Banks had also adopted the same technology to increase access and utilisation of financial services among the underserved. USSD is a popular technology in Uganda. Kobo collect is also being widely used  by not for profit organisations especially in humanitarian setting. Since majority of Ugandans live in rural communities, technology which requires no internet access is most applicable. Over 80% of private clinics, health facilities and hospitals use clinic master to manage the facilities.

If teen moms and their babies receive maternal and child health care education and services through affordable and accessible means that's community health extension workers and the use of USSD mobile technology; which incorporate both traditional and modern networks; then they will be empowered with the knowledge they need to ensure  that they and their babies access and utilise quality maternal and child heal care services information. IF YETU continues to provide quality health care services and education. This will lead to increased uptake of quality maternal and child health care among teen moms and their babies. There will be more babies fully immunised, and less preventable maternal infant mortality.

YETU Health Centre currently serves 70 individuals on average per month at the health facility premises. The facility serves 150 women and adolescent girls during the community outreaches led by the community health extension worker. In one year we hope to serve 360 teen moms, 500 women above 24 years, 100 men and boys and 500 babies/children below 5. In Five years we hope to serve 5 times more the more we will serve in one year. That is 1800 teen moms, 2500 women above 24 years, 500 men and boys, 2500 babies/children below 5. In total we will reach 1460 individuals in one years and 7300 in 5 years.

We aim to improve health outcomes for rural youth especially in reproductive health. To achieve this, YETU operations are currently based in Luwero District with coverage of three districts in the rural communities in central Uganda. Late last year (2019), YETU started  health facility to offer quality and affordable reproductive health care to the youth. To run the facility, YETU has employed nurses, midwives, social workers, a doctor, laboratory technician and community health extension worker. Before that we conducted regularly community health education outreaches and medical camps. Youth who needed services would then be referrals to health care facilities. We hope to grow the health facility into a well equipped hospital which can offer quality and affordable health care to a bigger population. YETU also works in partnership with local government and is a part of several civil society networks including the coalition to end maternal mortality ion Uganda.

 We aim to increase access to sustainable financial services by rural youth. To this effect our financial inclusion program was registered as a company in 2016 to offer affordable micro fiancé to youths. This gives out micro loans between 100-300 USD and serves over 700 youths currently. The programs also offers entrepreneurship and business education to youth. For youth who have grown their enterprises and need bigger financing, we link them to banks and other financial services' providers.

Our major barriers is the finances to expand and serve more people. The need is there, the will and vision we do have but the finances are constraining. For example whereas we would love to have the clinic master software for the health facility, we can not afford to purchase it or even use any technology which will require us to make monthly subscription payments.

We are looking for resources within us to meet our growth needs, we are creating partnerships and networks from which we can source support to grow. We are also starting an internship and volunteer program to increase our human resource capacity. Overall we are building an organisation with capacity to grown and sustain this growth.

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Full time staff 6

Part time staff 4

Voluntary staff 4

Edith our founder and also social worker, has worked with non profit organisations managing health programs for over 10 years now. She holds BA Social Sciences and MA Human Rights from Makerere University. Before starting YETU she worked with USAID funded health projects and was a Global Health Corps Fellow.

Our midwives Winnie and Racheal both hold Diplomas in midwifery and worked with the Shanti Uganda Society birth house for over 3 years before joining YETU.

Our nurses Esther and Ritah graduated from Mulago School of Nursing and Midwifery. Esther worked with several children's clinics and pharmacies before joining us as head of our health programs. Ritah volunteered with Luwero Hospital for over 9 months.

Our community health extension workers are part of the village health team government structures which also serves as health centre one. (first level of health care at village level). These have received vast training in homebased care and have worked with several government and civil society funded health interventions. 

Our lab technician Sarah was trained by Mildmay and has worked for nonprofit health facilities for 5 years.

Our supervising doctor is a consulting intensivist with over 8 years work experience. He holds an MBCHB and MMed   Anaesthesiology from Makerere University and he was a critical care fellow at University of British Columbia.

We also do have support staff, a guard and a cleaner.

YETU currently works in partnership with 2 actors namely;

The coalition to end maternal mortality; this a platform were civil society engage government to improve the policy environment and funding to the health sector. Members also do research and disseminate to reinforce each others work. The members also share best practices to be replicated in other areas.

The District Directorate of Health Services, these play a supervisory role foe all health facilities within the district. They also donate medical supplies and equipment to good performing health facilities.

Our direct beneficiaries are women in reproductive age below 35 years (youth) and their new born babies and children below 5. We provide them with quality, affordable, accessible and available health education, immunisation, USSD health messaging, laboratory services, family planning and contraception, birthing services, immunisation, medicines, information, education and communication materials. These products and services are provided through interaction at out health facility or at the homes of our beneficiaries through community health extension services. We also provide these services through USSD communications. Once in a while we host radio talks shows on health. Our beneficiaries need quality health care to improve their health outcomes and that of their babies and children. When our target population is healthy, then they can engage in more productive work and improve their livelihoods. Also it reduces the number of babies/children who fall victim of immunisable diseases and loose their lives. In the long run, we are contributing to reducing preventable maternal and infant mortality.

Whereas we have benefited from donations and grants, our major path to financial sustainability is service subsidisation. All our clients pay a small fee to cater for our administration costs. We are also creating a lot of in-kind donations partnerships where we receive medical supplies and IEC materials free of charge. Our financial inclusion program also charges a small interest in order to sustain its self. We are also using crowdfunding pages (global giving) which don't expire but rather we just have to keep increasing our target amount (donation goal).

Solve is a platform for us to network, learn best practices from solvers who are doing similar work and to amplify our work. Solves will offer to us the needed mentorship we need to advance our social enterprise. Most importantly if we are selected as solvers we will access the much need funding to grow and serve more teen moms and their babies.

We feel marketing, media and exposure will advance our efforts in amplifying our work and pull the funding we need to grow. We also need to refine our business model since we have two but very different initiatives that is financial inclusion and reproductive health as an organisation.

We don't have particular names for now, but we would love for our staff to all be able to take the MIT relevant courses so that we better serve our community.

YETU advances the wellbeing of women and girls through providing affordable and quality health care and inclusive financial services. We use USSD and face to face interactions to confer knowledge and services.

We work to advance vaccine uptake and to ensure children are fully immunised before they turn 5 years of age. This is in line with the Uganda National Expanded Programme on Immunisation and the overall national health policy.