Training of Motorcycle (Boda-Boda) Riders to Improve on Maternal Referrals from the Community in Selected Districts of East –Central Region, Uganda:

Abstract

Uganda has a reproductive health situation characterized with a high maternal mortality ratio (MMR) of 336 per 100,000 live births and neonatal mortality rate (NMR) of 21.4 per 1,000 live births respectively. In East Central Uganda, it is at 346 per 100,000 live births and 27 per 1,000 live births respectively. The MMR and NMR are higher in rural areas, where mothers are poor, less educated and there is difficulty in communication and transport. This leads to failure of the mothers to reach the healthcare centre in time or not going there at all. Studies indicate that training of village health teams, health workers, and political leaders among other stakeholders on maternal child health (MCH) have been conducted in the past as a strategy to improve MCH. However, commercial motorcycle riders (locally known as boda-boda) who transport majority of rural mothers from community to health facilities have often been excluded in such trainings. Motorcycle riders (boda-boda) therefore lack knowledge on maternal and child health. This study focused on training commercial motorcycle riders to improve maternal referrals from community to health facilities in Iganga and Bugiri districts in East Central Uganda. To ease telephone communication and follow up among the riders, mothers, VHTs and health workers at no cost, a closed caller group was created. This study used a non-randomized control trial study design of community intervention. Four sub counties were selected in the intervention and 4 in the control arms respectively. The study population consisted of pregnant mothers in their third trimester whose sample size of 534 was randomly selected (503 were recruited). Simple random sampling and purposive sampling techniques were employed. Self-administered questionnaires, key informant interviews, focus group discussions, registers/HMIS/DHIS2 and observation checklist was used to collect both quantitative and qualitative data. Findings revealed that training of boda-boda riders and initiating of the closed caller group has the potential to contribute to addressing the challenges associated to community referral needs for pregnant mothers in the 3rd trimester. This adds credence to the need for rolling out of training of boda-boda riders as well as the closed caller group initiative to a greater geographical area and to different ethnic groups and other lower resource settings in the sub Saharan Africa.