## **Trustees’ Annual Report for the period**
**From 01/12/2021 Period start date To 31/12/2021 Period end date**
**Charity name: Midwives at Maternity Azur (MAMA)**
## **Charity registration number:1173745**
## **Objectives and Activities**
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SORP
reference
Summary of the purposes Para 1.17 To promote and protect, for the benefit
of the charity as set out of the public, the good health of the
in its governing people in Hoima and Kikuube Districts,
document Uganda particularly in relation to
maternity care, women’s health and
sexual health. In particular this is
achieved by providing support to Azur
CHC IV in Hoima Town, to deliver high
quality healthcare for patients across
Hoima District.
Provide training, mentoring,
knowledge transfer and support to
healthcare workers at Azur CHC IV and
MAMA clinics and at health centre in
the surrounding area.
Promoting good healthcare practices
and support high quality care at the
clinic and in the surrounding area.
To raise awareness and promote
understanding in the UK, particularly
amongst healthcare professionals, of
the unique challenges faced by
healthcare workers, and women at
Azur CHC IV and in the community in
the surrounding area in relation to
maternity care, women’s health and
sexual health.
Summary of the main Para 1.17 Running two rural midwifery-led health
and 1.19
activities in relation to clinics and supporting the maternity
those purposes for the unit at a private not for profit hospital
public benefit, in in Hoima town;
particular, the activities, Healthcare staff training;
projects or services Between Jan and Dec 2021 this
identified in the included moving both clinics to new
accounts. premises allowing us to expand and
improve our services;
Maintained good relationships with our
partner Azur CHC IV and district health
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officers.
Statement confirming Para 1.18 As trustees we work hard to ensure all
whether the trustees our decisions are made for the benefit of
have had regard to the our beneficiaries in the Hoima and
guidance issued by the Kikuube districts. We use our existing
Charity Commission on knowledge and skills to enhance the work
public benefit we do and to guide who we work with in
order to meet our objectives.
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## **Additional information (optional)**
You may choose to include further statements where relevant about:
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SORP reference
Policy on grant making We are not a grant making
Para 1.38 organisation.
Policy on social N/A
investment including Para 1.38
program related
investment
Contribution made by Due to the Covid pandemic, volunteer
volunteers Para 1.38 visits to Hoima were more limited than
usual. Two of our Trustees made visits
to Hoima for periods of one month or
more as volunteers (an obstetrician
and a midwife). In addition, two further
doctors (a GP and a Consultant
Physician) volunteered in our clinics for
shorter periods, teaching our Clinical
Officer, and two senior midwives were
able to deliver midwifery update
sessions on emergency skills,
concentrating on postpartum
haemorrhage, sepsis and neonatal
resuscitation.
Other N/A
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## **Achievements and Performance**
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SORP reference
Summary of the main Both clinics have continued to go from
Para 1.20
achievements of the strength to strength. Kyarushesha in
charity, identifying the particular is much busier than in 2020,
difference the charity’s with more than double the number of
work has made to the births, and more than 30% more
circumstances of its antenatal visits. The summary figures
beneficiaries and any for both facilities are below:
wider benefits to society Runga HC II:
as a whole. - Antenatal visits 1624, monthly
mean 135
-
Births 207, monthly mean 17
-
Maternity admissions 273, monthly
mean 23
-
General outpatient appointments
681, monthly mean 57
-
Maternity referrals to hospital 42,
monthly mean 4
-
General referrals to hospital 26,
monthly mean 2
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**Kyarushesha MAMA Grace Clinic: -** Antenatal visits 4666, monthly mean 389 **-** Births 556, monthly mean 46 **-** Maternity admissions 1557, monthly mean 130 **-** General outpatient appointments 1791, monthly mean 149 **-** Maternity referrals to hospital 143, monthly mean 12 **-** General referrals to hospital 152, monthly mean 13 In 2021 we commenced and completed an ambitious building project to construct new, purpose-built premises for our clinic in Kyarushesha. This clinic had opened in rented premises in March 2020. It became clear during 2020 that we needed more space to deliver the services required by the local community. Furthermore, our landlord proved to be a challenging individual (for example diverting our electricity to supply his house) and the rental costs were a significant outgoing. With a view to expanding and enhancing our services, and to improve the long-term sustainability of the clinic (by removing £500pcm rent from the running costs), in December 2020 we had decided to start fundraising for a building project. After we had raised about 50% of the projected cost (total £50,000), the project commenced in January 2021. Despite the Covid pandemic, we completed the fundraising through a mixture of donations from both individuals and institutions, plus grants from three charitable trusts: The Northwood CT (funds donated in 2020), The Vardy Foundation and The Kitchen Table Charities Trust. The build was completed on schedule at the end of May 2021, with the clinic being opened the day after we moved in. The final spend was £52,030.63 (<5% over the original budget).
Having our own premises means they are designed for our current needs and with space to develop our services to include a laboratory and ultrasound facilities. Having the new premises enabled us to have a designated male and paediatric ward for inpatients, as well as facilities for isolation if required. Toilet blocks and wash areas,
including disabled access, were built to a high standard. We will now be able to register the clinic independently as a Health Centre III (rather than under the umbrella of our Ugandan partners), which will bring financial and resourcing benefits. In October 2021 the new clinic was formally opened by the Bishop of Kitara Bunyoni Diocese and renamed MAMA Grace clinic in memory of one of our Uganda midwives who sadly passed away in 2018. Due to the threat of rising water in Lake Albert we relocated our Runga clinic so it was further away from the edge of the lake. The new premises offers inpatient and outpatient areas, plus staff quarters and stores for equipment, medications and vaccines. All our services had minimal interruption while the move was taking place. Local builders ensured the new premises were adapted to our needs. Both clinics run fortnightly childhood immunisation clinics. We have engaged with the Ugandan Red Cross Organisation to host regular blood donor sessions. We have strengthened links with the local communities, gaining feedback for our services and patient experiences. We have used local drivers and their vehicles to provide emergency transport to those patients requiring a higher level of care. Through our funding from UK Aid, we had a UK-registered senior midwife resident in Uganda throughout 2021 overseeing our projects, and also offering one-to-one support and training to our midwifery staff in Uganda.
We managed four visits by two of our trustees (obstetrician and senior midwife), to support our in-country UK midwife and local staff in their practice.
We have supported local midwives in practice to enhance their clinical and managerial skills. This was particularly with a view to handing over the full-
time management of the Kyarushesha clinic to our Ugandan colleagues in February 2022, at the end of the UK Aid grant.
## **Additional information (optional)**
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You may choose to include further statements where relevant about:
Achievements against As detailed above we met the
Para 1.41
objectives set objectives we had set for 2021, which
were to construct new purpose-built
premises for the Kyarushesha Clinic,
and to move the Runga Clinic into new,
larger premises (still leased).
In addition to this both clinics
continued running throughout, and we
increased the proportion of women
receiving antenatal care in
Kyarushesha who then decided to
deliver their babies with us (from 38%
in 2020, to 51% in 2021). This is in line
with our goals to increased skilled birth
attendance and health facility delivery.
Anecdotally, we have reduced the
number of deaths in the communities
we work in. This was reported to us by
the diocese who before we opened the
clinics would have overseen a higher
number of burials.
Twice weekly health education sessions
at our clinics have improved the
mothers’ knowledge of when they
should seek help in pregnancy,
amongst other topics.
Performance of We have successfully generated
Para 1.41
fundraising activities enough income to cover all the
against objectives set necessary costs of the charity’s
activities.
The UK Aid Direct Small Charities
Challenge Fund grant (start date Feb
2020) has continued, and we have met
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all the reporting standards set by
them.
We were successful in raising the funds
required for the building project
(£52,000) through donations from both
individuals and institutions, and by
successfully applying for grants from
charitable trusts (with a success rate of
3/8, 38% - higher than that across the
sector).
In addition to this we increased our
regular monthly donations in
anticipation of the need to cover the
running costs of both clinics after the
end of the UKAid Direct SCCF grant (31
Jan 2022).
Several individuals completed
sponsored sporting events to raise
money for us, and as usual in
November 2021 we took over the
Rotations Charity Shop in Hampshire,
raising more than £1000.
Investment performance N/A
Para 1.41
against objectives
Other N/A
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## **Financial Review**
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Review of the charity’s Para 1.21 The years 2020 and 2021 have been
financial position at the very ambitious for our charity, almost
end of the period quadrupling our turnover and with
some major projects successfully
completed (despite the Covid-19
pandemic). We aim to increase the
unrestricted reserves in 2022 following
this period of expansion. We are now
focussing on a period of stability, to
cement the sustainability of our
projects to ensure they continue to
benefit the communities we serve in
the long term. We have increased our
regular monthly income to almost
cover the day-to-day running costs of
our projects, but still rely to some
extent on ad hoc fundraising and
grants.
Statement explaining the Para 1.22 The Covid pandemic has limited some
policy for holding fundraising activities, so we need to
reserves stating why they concentrate on increasing our
are held unrestricted reserves to ensure our
future sustainability.
Amount of reserves held Para 1.22 £1253.16
Reasons for holding zero Para 1.22 N/A
reserves
Details of fund materially Para 1.24 Nil in deficity
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in deficit
Explanation of any Para 1.23 No uncertainties
uncertainties about the
charity continuing as a
going concern
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## **Additional information (optional)**
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You may choose to include further statements where relevant about:
The charity’s principal Restricted funds:
Para 1.47
sources of funds UKAid Direct Grant £17,729
(including any The Vardy Foundation (grant for
fundraising) building project) £13,500
The Kitchen Table CT (grant for building
project) £5500
Unrestricted funds:
Donations from individuals make up
the majority of the remainder of the
funding, together with fundraising
activities.
We were also in receipt of some
donations from institutions and
companies known to us.
The two clinics charge small sums (less
than cost) for their services – all of
which goes directly back into the
running costs in Uganda, and is not
transferred to the UK (this appears as
clinic income in the Audited Accounts).
Investment policy and N/A
Para 1.46
objectives including any
social investment policy
adopted
A description of the We work in a high-risk country, with
Para 1.46
principal risks facing the multiple challenges including infectious
charity diseases, governmental instability,
crime and corruption. The global Covid-
19 pandemic has further complicated
running a small international
development charity.
The UK Government has reduced its
commitment to spending on
international aid from 7% to 5% of
GDP, which immediately led to the
FCDO cancelling all future grants from
the UKAid Direct Small Charities
Challenge Fund. This did not impact
the grant we were in receipt of,
however, does mean we can’t apply to
them for a follow-on grant for our
projects.
The current economic climate makes
charitable fundraising more uncertain.
We have compiled a comprehensive
risk assessment/register for our work
and volunteers in Hoima, This has been
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approved by UK Aid Direct as part of holding a grant with them.
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Other
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## **Structure, Governance and Management**
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Description of charity’s
trusts:
Type of governing Para 1.25 Constitution
document
(trust deed, royal
charter)
How is the charity Para 1.25 CIO
constituted?
(e.g unincorporated
association, CIO)
Trustee selection Para 1.25 Trustees are appointed by the board of
methods including details trustees.
of any constitutional
provisions e.g. election to
post or name of any
person or body entitled
to appoint one or more
trustees
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## **Additional information (optional)**
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You may choose to include further statements where relevant about:
Policies and procedures We have a number of polices
Para 1.51
adopted for the induction (approved by UKAid Direct) relating to
and training of trustees management and training of Trustees
and volunteers, including safeguarding.
We also have clinical guidelines and
operational guidelines for staff to refer
to as needed, approved by our trustees
and our local medical staff.
The charity’s In 2021 we had three trustees
Para 1.51
organisational structure managing the charity and projects
and any wider network from the UK, some of whom visit
with which the charity Hoima on a regular basis to support
works staff and monitor projects. We have no
paid staff in the UK, keeping our
overheads extremely low.
We had one MAMA member of staff
working in Uganda for a fixed two-year
term (1 February 2020 – 31 January
2022), who was paid a stipend. She is
a senior midwife, who oversaw all our
projects, and was involved with both
recruiting and training Ugandan staff
as well as working clinically to support
our projects.
In Hoima, Uganda, MAMA works closely
with Azur Christian Health Centre IV
whose support is invaluable in running
our clinics and ensuring wages are
paid, we are registered with the correct
authority and data collection is collated
for the districts.
Our Runga clinic is now registered with
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the Hoima District Health Office. Our
own premises will allow us to now do
the same for the Kyarushesha clinic
with the Kikuube District Health Office.
We work closely with the local district
health officers for Hoima and Kikuube
to ensure we offer high standards of
care and follow local and international
guidance.
We work with the local communities we
serve, including village and church
leaders (although our organisation is
non-religious), to enable us to offer
services needed for their geographical
areas.
Relationship with any MAMA has a good working relationship
Para 1.51
related parties with a number of local organisations in
the Hoima District, and we also have a
partner organisation, Azur Christian
Health Centre, with who we have a
current Memorandum of
Understanding. We base our maternity
services here, and with their staff we
offer satellite maternity services in
Hoima and Kikuube Districts. Regular
meetings with Azur’s management and
senior midwives ensure we have good
communication channels and keep up
to date with the staff and our clinics.
Through Azur we pay staff wages and
running costs of our clinics, ie. fuel,
vehicle and pharmacy. We offer regular
support to Azur, both through
volunteers, training and financing
some of their midwives.
Other N/A
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## **Reference and Administrative details**
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Charity name Midwives at Maternity Azur
Other name the charity MAMA
uses
Registered charity 1173745
number
Charity’s principal 1 Church View
address Hook
RG27 9HN
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## **Names of the charity trustees who manage the charity**
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Name of person (or
Dates acted if not for body) entitled to
Trustee name Office (if any)
whole year appoint trustee (if
any)
Rhiannon Chairperson 2107 to present Trustees
1
Grindle
Alexandra Secretary / 2019 to present Trustees
2
Kennedy Treasurer
Harriet Ivey Safeguarding 2017 to present Trustees
3
Lead
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
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Corporate trustees – names of the directors at the date the report was approved **Director name**
Name of trustees holding title to property belonging to the charity
**Trustee name Dates acted if not for whole year**
## **Funds held as custodian trustees on behalf of others**
Description of the assets N/A held in this capacity Name and objects of the N/A charity on whose behalf the assets are held and how this falls within the custodian charity’s objects Details of arrangements N/A for safe custody and segregation of such assets from the charity’s own assets
## **Additional information (optional)**
## **Names and addresses of advisers (Optional information)**
**Type of Name Address adviser**
**Name of chief executive or names of senior staff members (Optional information)**
## **Exemptions from disclosure**
Reason for non-disclosure of key personnel details
**N/A**
## **Other optional information**
**N/A**
## **Declarations**
## **The trustees declare that they have approved the trustees’ report above.**
**Signed on behalf of the charity’s trustees**
**Signature(s)** Rhiannon Grindle **Full name(s) Position (eg Secretary, Chair, etc) Date** 30/10/2022
## **Midwives at Maternity Azur (MAMA)**
Income & Expenditure Account
## Year Ended 31[st] December 2021
CHARITY REGISTERED IN ENGLAND & WALES REGISTERED NO 1173745
1
## **Income & Expenditure Account for year ended 31[st] December 2021**
||**2021**|**2020**|
|---|---|---|
||**£’s**|**£’s**|
|**Income**|||
|Unrestricted Funds|32,070|47,798|
|Restricted Funds|36,729|35,738|
|Gift Aid|6,729|4,761|
|Clinic Income|25,506|21,424|
|**Total Income**|**101,034**|**109,721**|
|**Expenditure**|||
|In Country (Uganda)|126,088|80,122|
|UK|-|5,000|
|Charity Insurance|140|140|
|Website|257|300|
|Bank Charges|495|289|
|**Total Expenditure**|**126,980**|**85,851**|
|**Surplus/(deficit) for the year**|**(25,946)**|**23,870**|
CHARITY REGISTERED IN ENGLAND & WALES REGISTERED NO 1173745
2
|**UK Bank Account**|**1st January**|**27,199**|**3,329**|
|---|---|---|---|
|||||
|**UK Bank Account**|**31st December**|**1,253**|**27,199**|
_Accounts prepared by R C Stanhope (ACMA) August 2022_
CHARITY REGISTERED IN ENGLAND & WALES REGISTERED NO 1173745
3
CHARITY COMMISSION
FOR ENGLAND AND WALES
Independent examinerfs
report on the accounts
Report to the truste&sl
m¢mbers of
mwiveS at Matemity Azur IMAMAI
On accounts for the year
ond8d
31 DeGember 2021
Charity no
lif any)
1173745
S•t out on pagès
I report to the Iruslees on my examination of the accounts ol the above
charity I the Trust'l for the year ended
R?$ponslbllbtie¥ and As the charity trustees of the Trust. you are responsible for the preparatlon
basls of report of the accounts in accordan with the requlrements of the Charities A
20111lhe Acfl.
I report In respect of my examination of th8 Trust's accounts carried out
under section 145 of the 2011 Act and in carrying out my examination, I
have followed the applicable Dlrections given by the Charity Commission
under sethon 145lSllbl of thè Act.
I have ccimpl8tad My examination. I confirm that no material matters have
Com& to my attentlon (other than th3t disclosed below'l in ¢onnection wth
the examination which gives me cause to believe that in, any material
respect..
accounting records were not k8Pt in accordance with sectson 130 of
the Act or
the accounts do not accord with the accounting CordS
Independent
examlnerfs $tatement
I have no concerns and have come across no other matters in connection
with the examination lo which attention 5hoLJld be drawn order to enable a
proper understanding of the accounts to bg reached.
Please delele the knvords in the brackets ifthey do not apply.
Signed:
Date..
31
10
2022
Nam•'.
Rachel Stanhope
Relevant professional
qualificationl$l or body
Irf anyl-
4cmA
Addre5S:
IER
Octobor 2018
Only complgtè if the examiner needs lo highlight matters of concern Isee CC32,
Independent examination of charS(y acwunts.. directions and guidanc8 for
examin8rsl.
GNO h¢re bri•f d•tails of
any it8ms that th•
examlner wishes to
d15elose.
IER
October 2018