2023-12-31-accounts

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Trustees’ Annual Report for the period

From 01/01/2023 to 31/12/2023

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 (Azur Health Centre IV); • We have maintained the independent registration of Runga clinic as a health centre II, and took several steps towards being able to register Kyarushesha MAMA Grace Clinic as a health centre III; • Healthcare staff training; • Developing closer relationships with Hoima Regional Referral Hospital, via the Bunyoro LMNS and a partnership with the Buckinghamshire, Oxfordshire and West Berkshire LMNS in the UK. This included a visit to the Kyarushesha clinic by the Director of the Bunyoro LMNS, Dr Ibrahim Bwaga; • 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 Commission on public benefit	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 enhance the work we do and to guide who we work with in order to meet our objectives.

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

	SORP reference
Policy on grant making	Para 1.38	N/A
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 (total 27 weeks by midwives, one obstetrician for two weeks). An additional volunteer midwife went for 2 weeks, and an artist to decorate the clinic for a further 2 weeks. 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 Anne Savile & the West Side Knitters; Revd Heather Turner (& team); Sue Turnbull; Helen Quinan; Katie Fletcher; Deirdre Hassett; Fionnuala McCredie; Heather Mitchell’s mother; and Caryl Donaldson, Francoise and Elizabeth (the Oxted ladies). Liz Payne kindly donated four emergency kit bags from the charity Baby Lifeline, which have been invaluable for our midwives in Uganda.
Other

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 2023, Kyarushesha MAMA Grace Clinic was busier than ever. There were 6 stillbirths, no neonatal deaths & no maternal deaths: • 611 births, monthly mean 51 (compared with 575 in 2022); • 5877 antenatal visits, monthly mean 490 (compared with 5195 in 2022); • 3055 general outpatients’ appointments, monthly mean 255 (similar to 2021/2); • 319 family planning appointments, monthly mean 27; • 2251 maternity admissions, monthly mean 188 (compared to 1962 in 2022); • 1232 general admissions, monthly mean 103 (similar to 2021/2); • 133 pregnant & 37 non-pregnant referrals to hospital (monthly means 11 and 3 respectively). Runga Health Centre II had a similar year in terms of numbers, and once again had no maternal deaths nor

neonatal deaths, and just a single stillbirth: • 160 births, monthly mean 13; • 1282 antenatal visits, monthly mean 107; • 374 outpatient reviews, monthly mean 31; • 156 family planning appointments, monthly mean 13; • 250 maternity admissions, monthly mean 21; • 251 general admissions, monthly mean 21; • 21 pregnant & 5 non-pregnant referrals to hospital (monthly means 2 and 0 respectively). We managed 7 visits by three of our trustees (obstetrician and two senior midwife), and 2 trips by other volunteers, to support our Ugandan colleagues (for a total of 29 weeks of the year). One of our trustees now has her Ugandan Medical Registration, enabling her to volunteer at Hoima Regional Referral Hospital, strengthening our links with this facility. She spent two weeks volunteering there in November 2023, and is developing a relationship between the Bunyoro LMNS and the Buckinghamshire Oxfordshire and West Berkshire LMNS in the UK. We have employed a lab manager for the clinic in Kyarushesha, which was one of the steps we needed to do in order to register independently with the District Health Office. We funded four of our clinic staff (doctor at Azur CHC IV, our Clinical Officer, Clinic Nurse and lead midwife) to attend a trauma course in November 2023 run by the Primary Trauma Care Foundation in Hoima City. Baby Lifeline bags have been donated to Azur HC IV, EDPA Clinic in Hoima City, our Runga Clinic and Hoima Regional Referral Hospital.

Additional information (optional) You may choose to include further statements where relevant about:	Additional information (optional) You may choose to include further statements where relevant about:	Additional information (optional) You may choose to include further statements where relevant about:
Achievements against objectives set	Para 1.41	Our objective was always to continue to run the Kyarushesha clinic beyond the end of the UK Aid Direct SCCF grant (in Feb 2022), and so far we have been successful in achieving this. We now have a functioning lab at the Kyarushesha clinic and are well on our way to registering this clinic independently with the District Health Office.
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. We have continued to increase our regular monthly donations to approximately cover the day-to-day running costs of our activities in Uganda. Several individuals completed sponsored events to raise money for us. This included the son of a friend (Ndudim Nnochiri) of the Trustees doing a 7km sponsored walk in aid of his 7thbirthday.

		Following his trip to Hoima in the spring of 2023, Dimitri Kontizas, held a fundraising event in Athens, raising ~£500. As usual in November 2023 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

Financial Review

Financial Review
Review of the charity’s financial position at the end of the period	Para 1.21	In line with our expressed aim at the end of 2022, we have successfully increased the unrestricted reserves held by the charity to >£10,000 by the end of 2023, from <£1000 at the end of 2022. This has been in part due to increased regular monthly donations, which now cover almost all of the regular outgoings. This has allowed larger, one-off donations to be put to one side rather than spent on day-to-day costs.
Statement explaining the policy for holding reserves stating why they are held	Para 1.22	We have increased our unrestricted reserves in order to ensure our future sustainability. We do not yet have 6 months’ worth of unrestricted reserves, which would ultimately be the aim.
Amount of reserves held	Para 1.22	£10,370.39
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), and 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 2023 we had three 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. 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. We are in the process of doing 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.
		MAMA has a good working relationship with a number of local organisations in the Hoima

Relationship with any related parties	Para 1.51	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, e.g. utilities, vehicle fuel and maintenance. We pay our pharmacy, Nilkanth Pharmcy, directly. We offer regular support to Azur, both through volunteers, training and financing some of their midwives. In line with our aims from the end of 2022, we have succeeded in developing stronger relationships with Hoima Regional Referral Hospital and the Bunyoro Local Maternity and Neonatal System. We hope this will improve the referral pathways to higher facilities, thereby enhancing the quality of care available to mothers and babies we serve. 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 (ifany)
	Rhiannon Grindle	Chairperson	2107 topresent	Trustees
	Alexandra Kennedy	Secretary	2019 topresent	Trustees
	Sofia Giannopoulou	Treasurer	2022 topresent	Trustees

– 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 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

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) Position (eg Secretary, Chair, etc) Date
	Rhiannon Grindle	Alexandra Kennedy
	Chair
	30/10/2024
	30/10/2024

Midwives at Maternity Azur (MAMA)

Income & Expenditure Account

Year Ended 31[st] December 2023

CHARITY REGISTERED IN ENGLAND & WALES REGISTERED NO 1173745

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Income & Expenditure Account for year ended 31[st] December 2023

	2023	2022
	£’s	£’s
Income
Unrestricted Funds	41,202	38,620
Restricted Funds	1,500	27,372
Gift Aid	12,107	4,704
Clinic Income	22,291	25,705
Vehicle Sale	-	6,934
Total Income	77,100	103,335
Expenditure
In Country (Uganda)	66,775	81,645
Vehicle Purchase	-	21,056
Charity Insurance	140	140
Website	330	300
Bank Charges	474	458
Total Expenditure	67,719	103,599
Surplus/(deficit) for the year	9,381	(264)

CHARITY REGISTERED IN ENGLAND & WALES REGISTERED NO 1173745

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UK Bank Account	1st January	989	1,253
UK Bank Account	31st December	10,370	989

Accounts prepared by R C Stanhope (ACMA) October 2024

CHARITY REGISTERED IN ENGLAND & WALES REGISTERED NO 1173745

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CHARITY COMMISSION FOR ENGLAND AND WALES Independant examinerfs report on the accounts Roport to the trustoesl members of Midwlves at Maternty Azur (MAMA) On accounts for tha year 31 Dec 2023 Charity no (If any) 1173745 S•t out on pagos I report to the trustees on my examination of the a(yx>unts of the above charity (Ihe Trusf) for the year ended Responslbllftlès and As the charty trustees of the Trust. you are responsible for the preparation basis of report of the accounts in accordance wth the requirements of the Charitses Act 2011 (Ihe Acr). I repyi in respect of my examinalion of Trusys a￿)Unts carried out urKler section 145 of th8 2011 Act and in cAryir¥J out my examinab'on. I have followed the ap￿IcaLle Direclions given by Ihe Charity Commission un(Jer secon 145(5Xb) of th8 A I have complet8d my examinatlon. l (yjnfirm that no material matters have come to my attention (olher than that disclosed below") in connection wlth the examination thich glves me Cause to bel￿e that in. any material Independent examlnetrs statement accounting records were not kept in accordanr£ with section 130 of the Act or the accounts do not auxyd with the a(￿Unting records I have no concems and hav8 come auoss no oth8r matt8rs in conn8Ction with the examinatlon to which attentK￿ should be drawm In order to enable a proper understanding of the a¢Ly)unts to bè reached. . Pleas8 delet8 the wonls in the brackets rfthey do not apply. Slgnod: Name: Relevant professlonal quallficatlon(s) or body Ilf any): ACMII Address: IER October 2018