Abstract
BackgroundIn rural India, mobile medical clinics are useful models for delivering health promotion, education, and care. Mobile medical clinics use fewer providers for larger catchment areas compared to traditional clinic models in resource limited settings, which is especially useful in areas with shortages of healthcare providers and a wide geographical distribution of patients.MethodsFrom 2008 to 2011, we built infrastructure to implement a mobile clinic system to educate rural communities about maternal child health, train community health workers in common safe birthing procedures, and provide comprehensive antenatal care, prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV), and testing for specific infections in a large rural catchment area of pregnant women in rural Mysore. This was done using two mobile clinics and one walk-in clinic. Women were tested for HIV, hepatitis B, syphilis, and bacterial vaginosis along with random blood sugar, urine albumin, and anemia. Sociodemographic information, medical, and obstetric history were collected using interviewer-administered questionnaires in the local language, Kannada. Data were entered in Microsoft Excel and analyzed using Stata SE 14.1.ResultsDuring the program period, nearly 700 community workers and 100 health care providers were trained; educational sessions were delivered to over 15,000 men and women and integrated antenatal care and HIV/sexually transmitted infection testing was offered to 3545 pregnant women. There were 22 (0.6%) cases of HIV, 19 (0.5%) cases of hepatitis B, 2 (0.1%) cases of syphilis, and 250 (7.1%) cases of BV, which were identified and treated. Additionally, 1755 (49.5%) cases of moderate to severe anemia and 154 (4.3%) cases of hypertension were identified and treated among the pregnant women tested.ConclusionsPatient-centered mobile medical clinics are feasible, successful, and acceptable models that can be used to provide quality healthcare to pregnant women in rural and hard-to-reach settings. The high numbers of pregnant women attending mobile medical clinics show that integrated antenatal care with PMTCT services were acceptable and utilized. The program also developed and trained health professionals who continue to remain in those communities.
Highlights
In rural India, mobile medical clinics are useful models for delivering health promotion, education, and care
Our aim was to demonstrate that mobile clinics catering to pregnant women are feasible and acceptable models in rural India, to deliver education and antenatal care with human immunodeficiency virus (HIV)/sexually transmitted infection (STI) testing and management
Collaborating with the National Rural Health Mission, Public Health Research Institute of India (PHRII) staff trained 77 Auxiliary nurse midwives (ANMs) and 126 Accredited Social Health Advocates, whose total catchment area was over 250,000 persons in rural Mysore (Table 2)
Summary
In rural India, mobile medical clinics are useful models for delivering health promotion, education, and care. A report from the World Economic Forum reported that India holds the lowest rank in gender parity of the BRIC (Brazil, Russia, India, and China [countries of newly advanced economic development]) countries (114 of 142 total ranked countries), a ratio of female-tomale labor force participation of 0.36 (134 of 142), showing unequal economic opportunity and participation, a femaleto-male literacy rate of 0.68 (126 of 142), and the rank of second to last in terms of health and survival of women (141 of 142) [15] All of those statistics highlight the state of underserved women in India, who need healthcare, and education and health literacy. Improved access and provision of healthcare is especially important for pregnant women and infants in India
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