Lukuli's population is growing - as is demand for our services
The UNFPA 2011 report on the state of midwifery in Uganda notes a theoretical total fertility rate of over 6 whereas Europe, Asia and the Americas are all 3 or less. Estimates for Makindye set the population at 400,000 up from 299,000 in the 2001 Census. At Hope Clinic, we now delivery 15-20 babies per month. The huge concern we have is that there are so many babies that are being delivered and that women did not deliver in a health unit, and perhaps did not have enough ANC checks, nor an HIV test for her and the baby's safety. We now understand that the government staffed facility that is 3 miles away by road is closed at night and at weekends for maternity services.

Less space means starting sack gardens	Many women, many babies, every week	Mothers hear how spacing help them

We have been helped by Aggreko International to reduce the financial barriers through their sponsoring of a midwife's cost of employment, and by DFCU banking group donating Mama kits so that each mother saves the Shs 10,000 cost of gloves, cotton wool and other items. These are needed wherever she eventually delivers.

The rapid population growth, and far slower expansion of government staffed health units has led the Makindye local council and Hope Clinic to plan a public private partnership whereby the costs for ANC, deliveries and child immunisation that would normally be charged to the patient will be borne by the council so that the services are free of charge to the patients. The removal of user fees at government sites greatly helped access to services, but the nearest government site, at Kiruddu, is 5km away by road. We hope to expand to over 100 deliveries per month.

In 2010/11 the Belgian Development Agency (BTC) provided a grant of Euro 5,000 through which we have replaced older maternity instruments, bought a new steriliser and improved the diagnostic tools and machines including a foetal scope and ambu-bag for clearing the baby's airway.