Influence of Communication Systems for Community-Based Referrals on Maternal Outcome in the Selected Districts of East-Central Uganda.

Abstract

Many communication interventions in East – Central Uganda that have been aimed at increasing deliveries at health centres have proved to be futile. The innovation, communication and technology referred to as Closed Caller User Group (CUG) was introduced with the intention of reducing the communication gap between mothers and boda-boda riders for better community referrals to health centres. The study investigated the influence of communication systems for community-based referrals on maternal outcome (health centre deliveries) based on the observed increase in home-based deliveries with the aid of relatives and Traditional Birth Attendants (TBAs). A non randomized control trial intervention study design was conducted in Iganga and Bugiri districts of East – Central Uganda. The study population consisted of 375 respondents including mothers, boda-boda riders and health workers in the intervention arm and 358 in the control arm randomly and some purposively selected. Self-administered structured questionnaires, in-depth and key informant interviews and focus group discussions were used to collect both quantitative and qualitative data. Quantitative data were analyzed using STATA version 14. Thematic analysis was done using atlas Ti 7 software. Results revealed that communication systems had a statistically significant influence on deliveries at health centres (p=0.000). This implies that the more pregnant mothers were exposed to communication systems, the more they delivered from health centers (OR=4.173). For communication systems, possession of phones by mothers (OR=4.200, p=0.000) and time interval boda-boda rider took to respond when contacted (21 – 30 min, OR=0.124, p=0.002 and 31 – 60 min, OR= 0.003, p=0.000) had an influence on maternal outcome (deliveries at health centres). In conclusion, mothers and boda-boda riders, and the innovation of closed caller user group to bridge the gap of communication, has potentially addressed the challenges associated with community referral needs in rural settings.