Evidence mapPaperPMID 41258185Full record

ArticleBMC global and public health2025

Evaluating the implementation of Bulamu healthcare's maternal and newborn program in Uganda.

Kylie Dougherty, Andrew Mukuye, Richard Businge, Ziyada Babirye, Samuel David Blizzard, Mackay Masereka, Yvonne Vaucher, Richard Siegler, James Healy, Peter Waiswa and 2 more

Abstract read
In one paragraph

Article in BMC global and public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Kylie DoughertyDepartment of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 Michigan Ave, Chicago, IL, 60611, USA. kylie.dougherty@northwestern.edu.ORCID http://orcid.org/0000-0002-3058-7709
Andrew MukuyeBulamu Healthcare, Kampala, Uganda.
Richard BusingeBulamu Healthcare, Kampala, Uganda.
Ziyada BabiryeDepartment of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda.ORCID http://orcid.org/0009-0002-9509-1517
Samuel David BlizzardDepartment of Psychiatry and Behavioral Sciences, University of Washington, Washington, USA.ORCID http://orcid.org/0000-0003-2625-4896
Mackay MaserekaBulamu Healthcare, Kampala, Uganda.
Yvonne VaucherDepartment of Pediatrics, University of California San Diego, San Diego, CA, USA.ORCID http://orcid.org/0000-0001-9227-396X
Richard SieglerBulamu Healthcare, Kampala, Uganda.
James HealyDepartment of Philosophy, Princeton University, Princeton, NJ, USA.
Peter WaiswaDepartment of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda.ORCID http://orcid.org/0009-0005-6250-8824
Margaret NakakeetoMinistry of Health Uganda, Kampala, Uganda.
Lisa R HirschhornDepartment of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 Michigan Ave, Chicago, IL, 60611, USA.ORCID http://orcid.org/0000-0002-4355-7437

Funding

Rotary Club of Kampala-Central GG-2240464
6 · The paper itself

Abstract

backgroundMaternal and newborn mortality remain critical challenges in Uganda, with rates exceeding global targets. Despite the existence of effective clinical guidelines, such as the World Health Organization's (WHO) Essential Newborn Care (ENC) and Helping Mothers Survive (HMS), implementation gaps persist due to training, resource, and systems-level barriers. Bulamu Healthcare launched a comprehensive maternal and newborn care capacity-strengthening program across eight districts in Uganda to improve clinical outcomes and health system performance. This model works with 104 existing public maternity facilities, which delivered more than 77,000 babies in 2024, and served more than 154,000 mothers and newborns in 2024.

methodsThis retrospective evaluation assessed the implementation of Bulamu's maternal and newborn health model using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance). The program included clinical training (WHO ENC, HMS) and mentorship, provision of essential supplies, and data-driven quality improvement. Data were collected from Uganda's national District Health Information Software (DHIS2) and Bulamu program monitoring tools from January 2023 to March 2025. Descriptive statistics summarized key implementation and outcome indicators.

resultsBulamu supported 109 health facilities, exceeding the initial target of 79, and established 12 functional neonatal care units (Reach). All facilities received the full intervention package. Over 250 maternity workers were trained, and 100% of district health workers in supported areas received ENC training (Feasibility). Live births in Bulamu facilities increased by 14% from 2023 to 2024, while maternal deaths decreased by 59% (from 17 to 7) (Effectiveness). The proportion of low-birth-weight newborns receiving kangaroo mother care rose from 54 to 62%, and newborn discharged alive rates improved from 80% to 96.4% (Effectiveness). Facilities demonstrated early signs of sustainability, with at least one trained maternal and newborn provider retained per site and local staff beginning to independently train peers.

conclusionsBulamu's integrated approach combining evidence-based interventions with targeted systems support improved care delivery and maternal-newborn outcomes in Bulamu-supported health facilities. Findings highlight the utility of the RE-AIM framework for real-world evaluation and support the value of embedded implementation research in strengthening health systems. Future research should examine cost-effectiveness, sustainability, and context-specific implementation mechanisms to inform scale-up and sustainability.

Indexed as

Essential newborn careHealth systems strengtheningHelping mothers surviveMaternal healthNewborn careRE-AIMUganda

Identifiers

PMID41258185
PMCPMC12632062

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.