September 3, 2020

Showing up for moms and babies: Ensuring respectful maternal care

Co-Authored by Watsi and Kupona Foundation

The COVID-19 pandemic has significantly impacted access to essential maternal and child health services. UNICEF recently highlighted a severe shortage of resources, including midwives, transportation disruptions that prevent pregnant women and mothers from accessing care, and patients’ general reluctance to visit hospitals due to risk of COVID-19 infection, meaning that when patients do seek care, their condition is often already critical. 

We know that women need to attend antenatal care visits, deliver with a skilled healthcare provider, have access to emergency surgery if the need arises, and receive postnatal care to ensure optimal health outcomes for both mothers and babies. In addition, babies born with congenital anomalies need timely access to care to help ensure they survive and thrive.

Harvard’s Maternal Health Task Force shared estimates that the disruption of health services due to COVID-19 has, in the best-case scenario, created 42,240 additional child deaths and 2,030 additional maternal deaths worldwide, every month.

Additional maternal and child deaths per month modeled by researchers’ scenarios

In short, maternal and child healthcare cannot wait and must be prioritized throughout every stage of this pandemic. Without access to life-saving interventions and responding to pregnant women’s needs, many more mothers and children will die from treatable and preventable conditions. 

What can be done to address this pressing global problem? Watsi and Kupona Foundation are proud to be a part of the solution to this global problem by providing respectful, high-quality, and patient-centered care to mothers and children in resource-poor settings during this time of crisis. This includes listening to pregnant and laboring women and responding to their needs. The investments we make now will ensure that our medical partners emerge from this crisis healthier, stronger, and more resilient in the years ahead.

Kupona Foundation is a nonprofit committed to delivering high quality healthcare to those who need it most in Tanzania. Our local partner, Comprehensive Community Based Rehabilitation in Tanzania  (CCBRT), is a leading specialist healthcare provider in Tanzania and a lynchpin in their healthcare system. Since 2009, CCBRT has designed and implemented a comprehensive maternal health system strengthening initiative that has put patient voices at the heart of service delivery. CCBRT works with 23 public health facilities across Dar es Salaam, one of the largest cities in Tanzania, to build their capacity for high quality, respectful, and inclusive maternal and newborn healthcare. Even though this work has become more challenging during COVID-19, mothers and babies can’t wait. 

As Dr. Brenda, a leading practitioner from Tanzania, recently shared in The Lancet, “To fulfill the complex demands of COVID-19 management while continuing essential reproductive health services, the number of maternity staff needs to be increased, capacitated, and provided with personal protective equipment, essential medicines, and access to integrated, relevant, and realistic guidelines on respectful maternity and COVID-19 services.”

Tanzania is one of ten countries in the world that, together, contribute to 61% of global maternal deaths and 66% of global newborn deaths. In Tanzania each year, 11,000 women die due to complications of pregnancy and childbirth, and 66,000 newborns will not survive their first month of life. It is estimated that over 80% of these deaths could be prevented if pregnant women had access to respectful maternity care.  

By training over 7,000 health workers on clinical skills across the childbirth continuum, including respectful maternity care practices, CCBRT’s Maternal Health team has enabled a 48% reduction in the maternal mortality ratio, a 19% reduction in the stillbirth rate, and improved the quality of care for over 800,000 mothers in Tanzania.

CCBRT midwife delivering antenatal care to a mother in Tanzania during Covid-19

Watsi is an international medical nonprofit that funds essential surgical care for patients facing extreme poverty across the Global South. We have been guided by our values throughout the current global health crisis, and led by our commitment to put our local medical partners and patients first in everything we do.  In response to local needs during COVID-19, Watsi has increased funding towards maternal care by more than 10% since March. In partnership with African Mission Healthcare, Watsi also launched two new hospital sites in southern Uganda and central Kenya to reach more mothers and children in need of essential healthcare now and in the years ahead.

Kyarimpa, a nursery school teacher from Uganda, is among the patients we have recently helped access safe labor and delivery care. Due to COVID-19 she has been unable to work and has consequently faced significant financial insecurity. Fortunately, Watsi donors were able to support her maternal care and she safely delivered a healthy baby girl.

Kyarimpa shared, “Thank you, Watsi, for supporting us financially and saving our lives. Thank you for being my pillar during these uncertain times. I will always remember your help.”

A proud new mom: Kyarimpa, a Watsi maternity care patient, and her baby.

Tibasiima is another Watsi patient who recently delivered her ninth child, a healthy baby boy. Both mom and baby are doing well thanks to the efforts of the talented frontline healthcare professionals at Rushoroza Hospital in Uganda. She and her husband work as small-scale farmers, but they have a difficult time providing for their large family. Tibasiima told us after her delivery:

“God sent us to Rushoroza Hospital. We were very lucky, we walked to Rushoroza Hospital because we had no transport means. Thank you, Watsi, for we had no way out. We shall take good care of our child through farming.”

Tibasiima, a Watsi maternity care patient, heading home with her new baby.

Although the world is facing unprecedented challenges as a result of COVID-19, we cannot afford to leave mothers and their babies behind because they are our future. We must continue to respectfully meet their unique and complex needs during the pandemic and beyond. Both Kupona and Watsi are committed to prioritizing the healthcare needs of mothers and babies,  amplifying their voices and experiences, and supporting frontline health workers to ensure we best serve our patients. 

We hope that you will join us at this critical moment in helping to lift up mothers and their babies for a brighter future. In doing so, we are confident that, together, we can emerge from this time of uncertainty with empowered families, healthier communities, and strengthened health systems. 

Join us today in creating a stronger tomorrow for mothers and their babies across the globe. 

Co-Authored by Mackinnon & Laura at Watsi with Susana & Paley at Kupona Foundation

May 14, 2018

Partnerships for Progress: Improving the health and wellbeing of children with disabilities

This month, Kupona Foundation launched a new partnership with the Dorothea Haus Ross Foundation to strengthen the comprehensive network of support available to children with disabilities and their families in Tanzania.

Funds will support training for parents/carers of children with disabilities, helping them to provide quality support for their children at home. Training will also be provided to government healthcare providers to strengthen delivery of rehabilitative services in healthcare facilities and community support units. At the community level, community events will increase awareness of rehabilitation services and promote inclusion. The grant will also facilitate knowledge exchanges between CCBRT and its peers in order to strengthen the network of community based inclusive development providers in the East Africa region. Combined, these activities will drive the sustainability of CCBRT’s established rehabilitation services, making quality care accessible to more children and their families.

Ken Goody, Foundation Executive at the Dorothea Haus Ross Foundation said, “At the Ross Foundation, we focus on alleviating the suffering experienced by vulnerable children and, when possible, strive toward the elimination of its root causes. We are thrilled to expand the Ross Foundation’s footprint in Tanzania by supporting this globally respected rehabilitation program, to make sustainable investments that strengthen the quality of rehabilitative care available to children with disabilities and their families.”

Unlocking opportunities for children with disabilities

Addressing disability during a child’s formative years is crucial to mitigate the impact of disability on health and development. More than half of children with disabilities in Tanzania do not attend school, limiting their access to education and future economic opportunity. Raising a child with a lifelong disability is also a significant challenge for parents and caregivers. With 86% of the Tanzanian population at risk of falling deeper into poverty because of healthcare expenses, families of a child with a disability are at particular risk for extreme poverty if they are unable to access affordable care for their child. Stigma associated with disability in Tanzanian communities also leaves children and their families excluded from their communities, and without a strong system of support. The dearth of skilled healthcare workers across the Tanzanian healthcare system exacerbates these challenges.

A comprehensive solution

CCBRT delivers high quality, specialist services at two rehabilitation centers: one in Moshi, serving rural communities in the north of Tanzania, and one in Dar es Salaam, Tanzania’s largest city. At these centers, CCBRT delivers high quality physiotherapy and occupational therapy, as well as special seating services and provision of assistive devices, including standing frames, prostheses and orthoses. In the community, CCBRT has established a network of Community Support Units in both Dar es Salaam and Moshi for the families of children with disabilities, providing a place for families to gather with their children, receive support from a trained physiotherapist/occupational therapist and develop a peer support system. CCBRT conducts home visits and community outreach to ensure long term support and follow up is provided to children with disabilities and their families in their home environment. CCBRT also uses training, lobbying and community awareness activities to build the capacity of parents, communities and government healthcare providers. This enables these groups to embrace their roles as primary caregivers and brings quality care closer to communities.

Abbey Kocan, Executive Director of Kupona Foundation said, “CCBRT has a 20+ year legacy of community-based rehabilitation work. Without trained caregivers and healthcare workers, an engaged and inclusive community, and a strong network of quality care providers, the impact of CCBRT’s efforts to deliver services to vulnerable children would be limited. The Ross Foundation’s contribution will act as a catalyst to enable the success of our overall program. We’re delighted to welcome them to the Kupona Foundation community.”

October 23, 2017

Kupona Foundation & Lavelle Fund for the Blind Launch Partnership for Sustainable Vision Care in Tanzania

We are delighted to announce our latest collaboration with Lavelle Fund for the Blind. Over the next 2.5-years the Lavelle Fund will support critical financial and technical investments, enabling the CCBRT team to scale the provision of low cost, high quality services to people living with blindness or visual impairment in Tanzania, and to sustain these critical services for future generations.

Photo credit: Sala Lewis

Blindness and visual impairment in Tanzania

  • In Tanzania, an estimated 1.1 million people are visually impaired and 33,000 are blind.
  • With an average household size of five, at least 4.7 million people are directly affected by blindness and visual impairment in Tanzania.
  • Up to 70% of cases of blindness or visual impairment can be treated or cured with surgery, medical intervention or assistive devices, but access to quality services is limited.
  • CCBRT’s immediate catchment area, Dar es Salaam, is one of the fastest growing urban centers in Africa, and Tanzania’s largest city. Dar es Salaam is on track to become a megacity, with a population of 10 million by 2025.
  • Though poverty rates have declined in recent years, about 12 million Tanzanians still live in extreme poverty, earning less than $0.60 per day.

Without intervention, individuals with preventable or treatable blindness and visual impairment struggle to access vital healthcare services, education or employment opportunities and are often excluded from community life. CCBRT provides high quality, affordable, comprehensive outpatient and surgical care to thousands of people every year to either restore their vision or provide long term support to people with permanent vision loss, enabling them to fully participate in their community. CCBRT is the largest provider of ophthalmology services in Tanzania, and its Disability Hospital in Dar es Salaam is one of only three facilities equipped to provide pediatric ophthalmology services nationwide. More than 60,000 people a year currently rely on CCBRT’s services, and Dar es Salaam’s growth means demand continues to increase.

Photo credit: Sala Lewis

Working together with global experts
Leveraging the advice and expertise of esteemed advisors from the world of social enterprise and sustainable eye care, the goal is to use investments in equipment, staff training, community outreach and facility refurbishment to increase both volume-driven patient revenue and efficiency-driven cost-savings. This will facilitate a 70% increase in the volume of cataract surgeries currently performed at the hospital and double the number of patients that receive care at no charge, while also reducing CCBRT’s dependence on volatile external aid.

The partnership will convene a technical advisory group comprised of three visionary leaders in the field of sustainable eye care. Mr. David Green, a MacArthur Fellow and Ashoka Fellow, helped develop the Aravind Eye Hospital in Madurai, India, the largest eye care system in the world and a blueprint for sustainable eye care in the Global South. Dr. Levi Kandeke is a pediatric ophthalmologist and pioneer of sustainable eye care in Burundi, East Africa. Ms. Penny Lyons is Executive Director of Seva Canada Society, an international eye care organization that provides funding and expertise to eye care partners and institutions worldwide.

“CCBRT is not only Tanzania’s largest provider of many core eye care services, it is also one with an exemplary record of service quality,” said Daniel Callahan, Board President at Lavelle Fund for the Blind. “The Lavelle Fund is proud to be supporting CCBRT and its partner Kupona Foundation in their current initiative to drive increased eye care volume, efficiency, affordability, and sustainability at CCBRT Disability Hospital. We’re also delighted to see the contributions of experts like David Green and the team at Seva Canada, as we facilitate knowledge exchange from a range of successful sustainable eye care initiatives across the world.”

This partnership, combining financial resources and ongoing technical support from world-renowned experts, will ensure that CCBRT can reach more people in need of affordable, high quality, specialized services to restore their sight, while investing in organizational sustainability. This partnership is about ensuring that critical, high quality healthcare services are not only available today and tomorrow, but in ten years’ time.

The official press release for this announcement is available here.

September 11, 2015

People Making it Happen: UCLA Anderson School of Management

A collaboration for lasting change

At Kupona, we are committed to finding creative, high impact solutions to the challenges facing CCBRT as they continue to strengthen their reputation as an expert provider of quality healthcare in Tanzania. We tap expertise across sectors, calling on innovative minds to share their knowledge and help us to build scalable solutions, all to ensure the longevity of CCBRT’s impact on the ground. Our recent project with a Strategic Management Research (SMR) team from UCLA Anderson School of Management, facilitated through support from Johnson & Johnson, highlights how Kupona unlocks access to a network of experienced, multi-disciplinary talent in the United States. This type of collaboration connects CCBRT to cutting-edge thinking, opportunities for partnership and innovative approaches that would be challenging to reach as a local Tanzanian NGO.

From Left to Right: Abbey Kocan (Kupona), Matt Mather, Derek Herrera, Chris Mora, Kim Hoang, Anastasia Melis (CCBRT), Heidi Pease

A severe shortage of skilled professionals
The need for high quality medical and managerial training in Tanzania is undeniable. There is a shortage of skilled professionals able to meet the healthcare needs of a growing population, and there is currently no established program of Continuing Medical Education for licensed medical professionals in the country. In the coming years, CCBRT will face a steep increase in internal training requirements with the recruitment of new staff for the CCBRT Maternity and Newborn Hospital. New staff will need to complete pre-employment training and credentialing, and be equipped to provide high quality care.

In the face of internal and external training gaps, CCBRT identified the need for a Training Center in Dar es Salaam. The vision is to establish a Training Center to equip healthcare and managerial professionals across the region with the skills they need to deliver high quality medical care. By addressing both internal and external training needs, CCBRT’s Training Center will improve operational excellence, patient care and outcomes throughout the entire organization, and provide a central location to support healthcare provider training across the East African region.

As planning for the Training Center gained momentum, it became clear that CCBRT needed to develop a strategic business plan if they were going to realize this vision and operate the Training Center in a sustainable manner. Given CCBRT’s limited internal capacity to conduct the necessary research and analysis, Kupona Foundation engaged the support of one of the top Executive MBA programs in the United States.

“The objective of the CCBRT Training Center project was to develop a strategic business plan that would empower CCBRT to plan for and eventually operate a high quality, high impact training center in a sustainable manner. The UCLA SMR team demonstrated their dedication to help us meet our objective from the beginning, when CCBRT’s Training Center project leader from Tanzania and I joined them in California for the project launch.”
Abbey Kocan, Executive Director, Kupona Foundation

Leading the way
Funded by Kupona’s longstanding partner Johnson & Johnson, a team of five Executive MBA students from UCLA travelled to CCBRT in Dar es Salaam, Tanzania in March 2015. Over the course of their project, the team travelled over 100,000 miles collectively, covering three continents and four countries. They completed over 300 hours of research, attended multiple development and global healthcare conferences, and conducted over 70 interviews with CCBRT’s patients, medical and management teams, global educators, government officials, and other non-profits. The team identified gaps and growth opportunities, conducted extensive market research and analysis, developed a working financial model to test several scenarios for sustainable operating models, and identified potential future international partnerships. The project highlighted the opportunity for CCBRT to become a recognized leader of quality training programs in the region of East Africa.

“Over the course of our two week visit to Tanzania and Kenya in March, we witnessed for ourselves the need for increased access to medical care and the vital role that CCBRT plays in the region.  We realized that the smallest of contributions and changes can have the biggest impact there.”
Matt Mather, UCLA Anderson School of Management Executive MBA ’15, Strategic Management Research consultancy team member

Turning challenges into opportunities
CCBRT is faced with a dynamic, fluctuating field of challenges, with the shortage of skilled professionals in country being one of the most critical risks facing the organization. As CCBRT’s sister organization in the United States, Kupona can help establish innovative partnerships and apply creative thinking, turning those challenges into opportunities for growth and long-term change across the region. Kupona would like to express gratitude to the UCLA team for their dedicated efforts and exceptional work, which provided a foundation for planning and establishing a sustainable Training Center, and is helping CCBRT continue to improve access to quality healthcare in the region by addressing the critical skilled human resources gap through training.

 

June 23, 2015

Partnerships for Progress

Kupona and Direct Relief

 

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Enabling access to high quality healthcare is the driving force behind everything we do at Kupona Foundation. Our sister organization, CCBRT, has a 20-year legacy of providing exemplary care for people with disabilities in Tanzania and has a strong reputation for quality services in the Tanzanian community. Safeguarding this quality is vital, not only to the lives of patients, but for the continued success of the entire organization.

Photo credit: Dieter Telemans

Photo credit: Dieter Telemans

Kupona is, therefore, delighted to announce a new partnership with Direct Relief, facilitating vital equipment and systems upgrades to CCBRT’s operating theaters. This investment will allow CCBRT to continue to provide high quality surgical care for thousands of patients with correctable impairments every year, including 550 fistula patients expected to receive care in 2015. Upgraded equipment will also enable CCBRT to provide better training opportunities for surgeons from across the continent.

“We are, of course, very excited that Direct Relief has committed funding for these vital systems and equipment upgrades. But this partnership doesn’t begin and end with a financial contribution. Direct Relief has vast experience in supporting healthcare providers in developing countries, and a well respected in-kind donation program for essential medicines and supplies, which we expect to begin soon. I’m particularly encouraged by the potential that this partnership has to make a significant contribution to the development of the CCBRT Maternity and Newborn Hospital as we enter the final phase of construction and focus upon detailed plans for opening and managing the new facility.”
– Abbey Kocan, Executive Director, Kupona Foundation

Direct Relief is a California-based non-profit organization whose mission is to improve the health and lives of people affected by poverty or emergency situations by mobilizing and providing essential medical resources needed for their care. They are the latest member of Kupona’s ecosystem of donors, doctors, academic institutions and partners who convene to support CCBRT as they build a brighter future for children, families, and communities for generations to come.

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