Emergency referral transport needs of pregnant women in rural Tanzania

Abstract

For pregnant women in rural Africa, delays in reaching a health facility are inevitable. When complications occur, unless transport is found quickly to reach a facility providing essential obstetric care promptly, morbidity and mortality are common outcomes. The study aimed to explore the emergency transport needs of rural pregnant women in Erri village, Babati District, Tanzania. Communities were selected purposefully. A crosssectional design was used, 250 women of childbearing age were interviewed, 12 men and 12 women participated in focus group discussions (FGD), and 7 women were interviewed using the critical incidence technique. Information on community awareness of women's needs for locally available and functional transport for emergency obstetrics referrals was obtained using a structured questionnaire, FGD and critical incident interviews. The questionnaire revealed that 75% of women with 7 years of school in this study, were more likely to seek help from the district hospital than women with 5 or fewer years of schooling. Women who lived nearer to emergency obstetric facilitates were more likely to use these facilitates than those living far away. Having a bicycle in a household did not influence the woman's decision about where to seek help during an emergency. Seventy percent of respondents (43/61) who used a bicycle revealed that when women encounter emergencies it takes more than half a day to reach the district hospital. Almost every participant declared the hardship in accessing emergency obstetric care related to lack of funds and unavailability of the transport. During FGD women shared stories of mothers and newborns who had died on their way to emergency obstetric care. The study provides a small insight into the referral transport needs of pregnant women living in rural communities in Manyara region. Further participatory research is necessary to identify reliable and affordable transport options acceptable to pregnant women and their families; and evaluation is required to estimate the impact of emergency referral programmes on referral times and operational feasibility.