2022-12-31-accounts

Trustees’ Annual Report for the period

From 01/01/2022 To 31/12/2022

Charity name: Midwives at Maternity Azur (MAMA)

Charity registration number: 1173745

Objectives and Activities

	SORP reference
Summary of the purposes of the charity as set out in its governing document	Para 1.17	• To promote and protect, for the benefit of the public, the good health of the people in Hoima and Kikuube Districts, 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 activities in relation to those purposes for the public benefit, in particular, the activities, projects or services identified in the accounts.	Para 1.17 and 1.19	• Running two rural midwifery-led health clinics and supporting the maternity unit at a non- governmental, not for profit hospital in Hoima town; • Purchase of a replacement Toyota Hilux (the previous vehicle was a 1992 registration) to facilitate transport of patients, staff, equipment and medications to and from our clinics; • Healthcare staff training; • Expanding the services at Kyarushesha to include a laboratory and obstetric ultrasound; • Maintained good relationships with our partner Azur CHC IV and district health officers.
Statement confirming whether the trustees have had regard to the guidance issued by the Charity	Para 1.18	As trustees we work hard to ensure all our decisions are made for the benefit of our beneficiaries in the Hoima and Kikuube districts. We use our existing knowledge and skills to

Commission on public benefit

enhance the work we do and to guide who we work with in order to meet our objectives.

Additional information (optional)

Additional information (optional)	Additional information (optional)	Additional information (optional)
You may choose to include further statements where relevant about:
	SORP reference
Policy on grant making	Para 1.38	We are not a grant making organisation.
Policy on social investment including program related investment	Para 1.38	N/A
Contribution made by volunteers	Para 1.38	The volunteer trustees made 7 trips between them (two midwives for three trips of two weeks, and three trips of eight weeks; and one obstetrician for two weeks). A senior midwifery lecturer from Oxford Brookes University made a trip of two weeks, as did another obstetrician. We are so grateful to a host of knitters for providing us with knitwear to keep newborn babies warm. This is a vital part of safe newborn care, and these donations allow our staff to achieve this. These include Steph Ainsley & the Kidderminster Soroptemists, Anne Savile & the West Side Knitters, Deirdre Hassett & Heather Mitchell’s mother.
Other		N/A

Achievements and Performance

	SORP reference
Summary of the main achievements of the charity, identifying the difference the charity’s work has made to the circumstances of its beneficiaries and any wider benefits to society as a whole.	Para 1.20	In 2022, Kyarushesha MAMA Grace Clinic was busier than ever. There were 5 stillbirths, no neonatal deaths & no maternal deaths. • 575 births, monthly mean 48 (19 more than in 2021); • 5195 antenatal visits, monthly mean 433 (529 more than in 2021); • 3369 general outpatients’ appointments, monthly mean 281 (almost double that in 2021!); • 494 family planning appointments, monthly mean 41; • 1962 maternity admissions, monthly mean 164 (405 more than 2021); • 1480 general admissions, monthly mean 123 (493 more than 2021);

• 144 pregnant & 48 non-pregnant referrals to hospital (monthly means 12 and 4 respectively). Runga Health Centre II had a slightly quieter year, although had no maternal deaths nor neonatal deaths, and just a single stillbirth: • 168 births, monthly mean 14; • 1358 antenatal visits, monthly mean 113; • 493 outpatient reviews, monthly mean 41; • 120 family planning appointments, monthly mean 10; • 263 maternity admissions, monthly mean 22; • 358 general admissions, monthly mean 30; • 24 pregnant & 15 non-pregnant referrals to hospital (monthly means 2 and 1 respectively). We managed 7 visits by three of our trustees (obstetrician and two senior midwife), and a volunteer obstetrician, to support our Ugandan colleagues (for a total of 32 weeks of the year). We have supported local midwives in practice to enhance their clinical and managerial skills, and in February 2022 have handed over the running of both clinics to our lead Ugandan midwife (Jerome Barongo). We have employed a fourth full time, permanent midwife at the Kyarushesha clinic. In 2020, Cookham Medical Centre generously donated an ultrasound machine to MAMA. Due to the Covid-19 pandemic we were delayed in being able to ship this to Uganda, but in 2022 we achieved this and this is now installed in the Kyarushesha clinic. This enables women to access obstetric ultrasound services within our clinic, without needing to travel long distances. We had four Baby Lifeline emergency bags donated by Milton Keynes University Hospital, which we use for obstetric referrals from our clinics.

Additional information (optional) You may choose to include further statements where relevant about:

Achievements against objectives set	Para 1.41	The UK Aid Direct Small Charities Challenge Fund grant was completed successfully in February 2022, and we submitted the project completion report. The project was graded A+ by UKAid Direct, and feeback on the report is pasted below. Our objective was always to continue to run the Kyarushesha clinic beyond the end of

		the UK Aid Direct SCCF grant, and so far we have been successful in achieving this. We needed to replace our old vehicle, and have been able to do this, purchasing a 2009 registration Toyota Hilux in February 2022. We have successfully shipped the donated ultrasound machine to Uganda and installed it in the clinic at Kyarushesha.
Performance of fundraising activities against objectives set	Para 1.41	We have successfully generated enough income to cover all the necessary costs of the charity’s activities. In February 2022 we received an extremely generous one-off donation of £25,000 which covered the purchase of a replacement vehicle (Toyota Hilux) which is an invaluable component of our activites in Uganda. We have continued to increase our regular monthly donations to cover the day-to-day running costs of our activities in Uganda. Several individuals completed sponsored sporting events to raise money for us (including the Mongol Derby horse race, and a sponsored walk up the escarpment above the Runga clinic). As usual in November 2022 we took over the Rotations Charity Shop in Hampshire, raising more than £1000.
Investment performance against objectives	Para 1.41	N/A
Other		N/A

Figure 1: feedback from UKAid Direct SCCF project completion report

Financial Review

Review of the charity’s financial position at the end of the period	Para 1.21	The years 2020 and 2021 were very ambitious for our charity, almost quadrupling our turnover and with several major projects successfully completed (despite the Covid-19 pandemic). As planned, in 2022 we aimed for a period of stability, although we were very fortunate to secure a substantial one-off donation enabling the purchase of a replacement vehicle. In the aftermath of the Covid-19 pandemic we were not able to significantly increase the unrestricted reserves by the end of this financial year, but some expected income in early 2023 should help us to do this. By continuing to run all our projects in new premises, beyond the end of the UKAid direct grant, we have begun to cement the sustainability of our projects to ensure they continue to benefit the communities we serve in the long term. We have further 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 policy for holding reserves stating why they are held	Para 1.22	The Covid pandemic has limited some fundraising activities, so we need to concentrate on increasing our unrestricted reserves to ensure our future sustainability.
Amount of reserves held	Para 1.22	£989.35 (balance as of 31 Dec 2022)
Reasons for holding zero reserves	Para 1.22	N/A
Details of fund materially in deficit	Para 1.24	Nil in deficit
Explanation of any uncertainties about the charity continuing as a going concern	Para 1.23	No uncertainties

Additional information (optional)

You may choose to include further statements where relevant about:

The charity’s principal sources of funds (including any fundraising)	Para 1.47	Unrestricted funds: Donations from individuals make up the majority of our funding Fundraising activities – sponsored sporting events, charity shop (annually in November) Donations from institutions and companies Clinic income: 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 objectives including any social investment policy adopted	Para 1.46	N/A
A description of the principal risks facing the charity	Para 1.46	We work in a high-risk country, with multiple challenges including infectious 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 could not 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 was approved by UK Aid Direct as part of holding a grant with them.
Other		N/A

Structure, Governance and Management

Description of charity’s trusts:
Type of governing document (trust deed, royal charter)	Para 1.25	Constitution
How is the charity constituted? (e.g unincorporated association, CIO)	Para 1.25	CIO
Trustee selection methods including details of any constitutional provisions e.g. election to post or name of any person or body entitled to appoint one or more trustees	Para 1.25	Trustees are appointed by the board of trustees.

Additional information (optional)

You may choose to include further statements where relevant about:

Policies and procedures adopted for the induction and training of trustees	Para 1.51	We have a number of polices (approved by UKAid Direct) relating to 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 organisational structure and any wider network with which the charity works	Para 1.51	In 2022 we had four trustees managing the charity and projects from the UK, some of whom visit Hoima on a regular basis to support staff and monitor projects. We have no paid staff in the UK, keeping our overheads extremely low. Our one MAMA member of staff working in Uganda completed her fixed term contract (2 years) on 31 January 2022 as planned. She has been reinstated as a Trustee since her return to the UK. 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 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 related parties	Para 1.51	MAMA has a good working relationship 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. Our clinics need good quality facilities upstream to refer patients in need of a higher level of care to, so moving forwards, we plan to bolster our relationships with Hoima Regional Referral Hospital. One of our trustees has had her registration with the Ugandan Medical and Dental Practitioners Council approved, enabling her to volunteer there in the future. There are also plans to explore developing a partnership between the newly-established Bunyoro Local Maternity and Neonatal System (LMNS) and the West Berkshire, Oxfordshire and Buckinghamshire (BOB) LMNS in the UK. During this process we have developed connections with Obstetricians working at the Ministry of Health in Uganda, which we hope will be of benefit in the future.
Other		N/A

Reference and Administrative details

Charity name	Midwives at Maternity Azur (MAMA)
Other name the charity uses
Registered charity number	1173745
Charity’s principal address	1 Church View, Hook, Hampshire, RG27 9HN.

Names of the charity trustees who manage the charity

1 2 3 4	Trustee name	Office (if any)	Dates acted if not for whole year	Name of person (or body) entitled to appoint trustee (if any)
	Rhiannon Grindle	Chairperson	2107 topresent	Trustees
	Alexandra Kennedy	Secretary	2019 to present	Trustees
	Harriet Ivey	SafeguardingLead	2017 topresent	Trustees
	Sofia Giannopoulou	Treasurer	2022 to present	Trustees

– Corporate trustees names of the directors at the date the report was approved

Director name N/A

Name of trustees holding title to property belonging to the charity

Trustee name	**Dates acted if not for whole year **
N/A

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 for N/A 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

Declarations

The trustees declare that they have approved the trustees’ report above.

Signed on behalf of the charity’s trustees

Signature(s) Full name(s) Rhiannon Grindle Position (eg Secretary, Chair, etc) Date 29/10/2023

CHARITY COMMISSION FOR ENGLAND AND WALES Independent examiner's report on the accounts Report to the trusteesl members of Midwives at Matemity Azur {MADA4) On accounts for tho year ended 31 Dec 2022 Charity no (if any) 1173745 Set out on pages Iz3 I report to the trLth on my examinalton of th accou chartty (kne Trusf) forthe year ended 71112 7 102 Responsibifities and As the charity trustees of the Tnjst. you are responsbi le for the p￿ paration basls of report of the accounts in accordan￿ with the requirements of the Charities Act 2011 {"the Acr). ts ofthe above I report in respect of my examination of the Trust's ac¢ounts carriad out under *ction 145 of the 2011 Act atKJ in carrying out my exarnination, I have followed the applicable Directions glven by the Charity Commission under section 145(5Xb) of the ACL I have completed my examination. I confirm that no material matters have come to my attention (other than that disclosed below.) in connection wtth the examlnation which gives me cause to believe that In. any material respect: accounling re(xrds were not kept In accordance with section 130 of the Act or the accounts do not accord wilh the accounting records Independent examinerfs statement I have no COn￿mS and have come acros5 no other matters in connection with the examination to which attention should be drawn in order to enab18 a proper understanding of the accounts to be reached. ° Please delete the words in the b￿CketS rflhey do not apply. Slgned: Date: Name: Rachel Stanhope Relevant professional qualification(s) or body (If any): ACMQ Address: IER October 2018

Only complete rfthe examiner needs to highlight matters of concem (see CC32, Independent exarnination of charity accounts: directions and guidance for examiners). Glve here briaf detatls of any items that the examiner wishes to dlsclose. IER October 2018