Program to follow up discharged premature babies and orphans:

In 2008 it was noted that many premature babies and orphan babies did not return for their scheduled follow up visits to the hospital.

Out of 20 babies discharged from the hospital only 2 were brought back more than twice for follow up examinations and to collect nutritional supplies.

During the same period several mothers were discharged while still having problems with milk supply. Again very few returned even though the hospital was willing to provide supplies of formula. No reliable reasons could be found for the failure of patients to return for follow up appointments.

 It can reasonably be assumed that either:

• the babies died
• the mothers were either too weak or unable for other reasons to make the journey back
• other forms of milk or nourishment were used.
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From 2005 until 2010 World Relief had run a “Child Survival” project. This project was designed to reduce the morbidity and mortality of children under the age of 5 years. The unique structure of this project is that supervisors and promoters employed by World Relief trained and encouraged an army of volunteers in villages throughout the region to pass on best practice hygiene and healthcare to friends and neighbours. Included in these volunteers were representatives of all the local churches, as in many cases mothers of sick children contacted their pastor or priest before going to the hospital. Statistics showed a great reduction in preventable diseases and much improved health in the children.

When the World Relief programme finished, Kibogora hospital employed one of the supervisors and 12 of the promoters who are based at each of the 12 regional health centres. They are responsible for the promotion of good hygiene and nutritional education via the volunteers in the villages.

Arrangements have been made to link the at risk babies to this programme. Babies (and treated malnourished children) are put in contact with volunteer health workers who are able to follow up and encourage attendance at follow up clinics and also help to get supplies to the families with the at risk babies.

This seems to be having good results especially with malnourished children, but to date no statistics have been kept to monitor this method of follow up. The Social Affairs department & chaplaincy at Kibogora Hospital has been responsible for the development of these programmes but they have been limited by a lack of personnel and funds for travel etc. This has resulted in a limited number of community visits and a lack of statistical information.

A much more structured program is now being studied with a better long term strategy. This will involve an assessment of at risk babies and their mothers prior to their discharge from the hospital and regular follow up visits in their homes or community. They will be encouraged to make regular visits to the paediatrician now working at Kibogora Hospital. Where necessary we would hope to be able to provide transport to and from the hospital appointments. Links will be established with existing care structures at the local community level and with our community supervisor responsible for nutrition in the health district of Kibogora.