Online Program

Improving uptake of antenatal services in rural Uganda through a novel intervention: Community outreach, portable ultrasound and radio messaging

Wednesday, November 4, 2015 : 10:30 a.m. - 10:40 a.m.

William Cherniak, MD, CCFP, Bridge to Health Medical and Dental, Toronto, ON, Canada
Michael Silverman, MD, FRCP, FACP, Department of Infectious Diseases, Western University, London, Canada
Geoffrey Anguyo, MD, Kigezi Healthcare Foundation, Kabale, Uganda
Christopher Meaney, University of Toronto, ON, Canada
Sumeet Sodhi, MD, MPH, Family and Community Medicine, UNIVERSITY OF TORONTO, Toronto, ON, Canada
Objective: To determine if offering a free obstetric ultrasound through use of a portable ultrasound (pOBU) could increase the rates of women presenting for antenatal care (ANC) to mobile medical and dental outreach camps in rural Uganda.

Methods: A clustered randomized controlled trial was conducted by Bridge to Health in partnership with Kigezi Healthcare Foundation (KIHEFO) to determine the efficacy of pOBU in improving ANC in rural Uganda. The four-pronged approach of elimination of mother to child transmission of HIV was followed in the design of a structured maternal health camp (sMHC). Communities were randomized into receiving advertisements of pOBU or not in addition to word of mouth advertisement of ANC. The final three clinics were advertised by word of mouth and radio. Each cluster rotated through registration, pre-test counseling for HIV, routine ANC testing, family planning, and pOBU.

Results: In total 166 women presented to ANC over eight clusters. The first four clusters had an attendance of 59 patients (35%), while the last four (pOBU advertised) had an attendance of 107. Only 7 women attended clinic when sMHC was advertised via radio with no mention of pOBU.

Conclusions: By offering pOBU to women in rural Uganda those who typically deliver at home and are hesitant to engage in modern medicine were successfully encouraged to seek medical care and attend ANC. These women all received invaluable prenatal care in addition to receiving a pOBU. Barriers to health and education were broken through partnership and innovative health care strategies.

Learning Areas:

Program planning
Public health or related organizational policy, standards, or other guidelines
Social and behavioral sciences

Learning Objectives:
Describe the importance of appropriate messaging in increasing attendance antenatal care. Differentiate the utility of radio versus word of mouth in advertising healthcare services. Identify the importance of using incentives to improve healthcare engagement. Compare antenatal care attendance using standard governmental policies versus novel methods integrating portable ultrasound

Keyword(s): Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Family and Emergency Doctor working in the greater Toronto Area and the Executive Director of a not for profit medical and dental non governmental organization.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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