Abstract
Toll free mobile phone intervention was tested in one sub district of Bangladesh. Prior to implementation, we conducted a formative research to explore perceived advantages and disadvantages of mobile phone communication for maternal and neonatal complication management. We conducted in-depth interviews among twelve community skilled birth attendants and fourteen mothers along with their husbands. All husbands were supportive in their wives’ accessibility to their phone, but wives revealed disparity in access to husbands’ phone. The advantages identified were reduced cost of consultation and transportation to appointments with skilled providers, time saving during emergencies and controlling barriers to pregnant women’s mobility. Other direct benefit was consultation with health professionals to increase confidence of community based skilled birth attendants (CSBAs) in handling emergencies. Respondents sensed that determining the management without examining patient might affect the appropriateness in providing treatment, when the communication mode is only phone. Mothers and their husbands who communicated through mobile phone with providers for their health issue noted some other barriers: irritability from the provider’s side and switched off phones. Mobile phone access pathway should be explained to pregnant women, their husbands and service providers from the beginning of an intervention. The well designed e-health solutions based on evidence of formative research may have larger impact on quality of care in Bangladesh. Key words: Maternal and neonatal emergencies, mobile phone, barriers, rural Bangladesh.
Highlights
Universal access to reproductive health and rights was designated as a developmental goal at the 1994 International Conference on Population and Development (ICPD) (UNFPA, 1995)
In the World health Organization (WHO) country cooperation strategy 2008 to 2013, Bangladesh reported that Bangladesh continues to face a chronic shortage of and imbalance in the health work force skill mix and deployment for maternal and neo-natal health (WHO, 2008)
A mobile telephone intervention was developed and tested in Shahjadpur, a sub district of Bangladesh. The effect of this large interventional study will be measured through baseline and end line surveys. The objective of this large study is to assess the use of mobile phones in increasing communication about maternal and neonatal complications and increase in health care utilization from skilled providers
Summary
Universal access to reproductive health and rights was designated as a developmental goal at the 1994 International Conference on Population and Development (ICPD) (UNFPA, 1995). Bangladesh was one of the lowest subscribers for mobile phone (less than one telephone subscription per 100 persons); access to such mobile communication was a revolution for local villagers This provides them the direct access to agricultural commodity pricing and in addition, transfer of funds, access to medical services, contact with distant family members in family emergencies and medical situations etc. The effect of this large interventional study will be measured through baseline and end line surveys The objective of this large study is to assess the use of mobile phones in increasing communication about maternal and neonatal complications and increase in health care utilization from skilled providers. In the intervention unions the community based skilled birth attendants (CSBAs) are provided with mobile phone and the mothers with requisite information on mobile communication in their needs. The formative research findings helped in finalizing the requisite information for mothers as well CSBAs and SLG on mobile communication in mother’s need
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