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Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya
INTRODUCTION: Kenya’s progress towards reducing maternal and neonatal deaths is at present ‘insufficient’. These deaths could be prevented if the three delays, that is, in deciding to seek healthcare (delay 1), in accessing formal healthcare (delay 2) and in receiving quality healthcare (delay 3), a...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6528775/ https://www.ncbi.nlm.nih.gov/pubmed/31179030 http://dx.doi.org/10.1136/bmjgh-2018-001254 |
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author | Onono, Maricianah Atieno Wahome, Samuel Wekesa, Pauline Adhu, Catherine Kidiga Waguma, Lawrence Wandei Serem, Titus Owenga, Mildred Anyango Ong'wen, Patricia |
author_facet | Onono, Maricianah Atieno Wahome, Samuel Wekesa, Pauline Adhu, Catherine Kidiga Waguma, Lawrence Wandei Serem, Titus Owenga, Mildred Anyango Ong'wen, Patricia |
author_sort | Onono, Maricianah Atieno |
collection | PubMed |
description | INTRODUCTION: Kenya’s progress towards reducing maternal and neonatal deaths is at present ‘insufficient’. These deaths could be prevented if the three delays, that is, in deciding to seek healthcare (delay 1), in accessing formal healthcare (delay 2) and in receiving quality healthcare (delay 3), are comprehensively addressed. We designed a mobile phone enhanced 24 hours Uber-like transport navigation system coupled with personalised and interactive gestation-based text messages to address these delays. Our main objective was to evaluate the impact of this intervention on women’s adherence to recommended antenatal (ANC) and postnatal care (PNC) regimes and facility birth. METHODS: We conducted a prospective cohort study. Women were eligible to participate in the study if they were 15 years or older and less than 28 weeks gestation. We defined cases as those who received the standard of care plus the intervention and the control group as those who received the standard of care only. For analysis, we used logistic regression analysis and report crude and adjusted OR (aOR) and 95 % CI. RESULTS: Cases (women who received the intervention) had five times higher odds of having four or more ANC visits (aOR=4.7, 95% CI 3.20 to 7.09), three times higher odds of taking between 30 and 60 min to reach a health facility for delivery (aOR=3.14, 95% CI 2.37 to 4.15) and four times higher odds of undergoing at least four PNC visits (aOR=4.10, 95% CI 3.11 to 5.36). CONCLUSION: An enhanced community-based Uber-like transport navigation system coupled with personalised and interactive gestation-based text messages significantly increased the utilisation of ANC and PNC services as well as shortened the time taken to reach an appropriate facility for delivery compared with standard care. |
format | Online Article Text |
id | pubmed-6528775 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-65287752019-06-07 Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya Onono, Maricianah Atieno Wahome, Samuel Wekesa, Pauline Adhu, Catherine Kidiga Waguma, Lawrence Wandei Serem, Titus Owenga, Mildred Anyango Ong'wen, Patricia BMJ Glob Health Research INTRODUCTION: Kenya’s progress towards reducing maternal and neonatal deaths is at present ‘insufficient’. These deaths could be prevented if the three delays, that is, in deciding to seek healthcare (delay 1), in accessing formal healthcare (delay 2) and in receiving quality healthcare (delay 3), are comprehensively addressed. We designed a mobile phone enhanced 24 hours Uber-like transport navigation system coupled with personalised and interactive gestation-based text messages to address these delays. Our main objective was to evaluate the impact of this intervention on women’s adherence to recommended antenatal (ANC) and postnatal care (PNC) regimes and facility birth. METHODS: We conducted a prospective cohort study. Women were eligible to participate in the study if they were 15 years or older and less than 28 weeks gestation. We defined cases as those who received the standard of care plus the intervention and the control group as those who received the standard of care only. For analysis, we used logistic regression analysis and report crude and adjusted OR (aOR) and 95 % CI. RESULTS: Cases (women who received the intervention) had five times higher odds of having four or more ANC visits (aOR=4.7, 95% CI 3.20 to 7.09), three times higher odds of taking between 30 and 60 min to reach a health facility for delivery (aOR=3.14, 95% CI 2.37 to 4.15) and four times higher odds of undergoing at least four PNC visits (aOR=4.10, 95% CI 3.11 to 5.36). CONCLUSION: An enhanced community-based Uber-like transport navigation system coupled with personalised and interactive gestation-based text messages significantly increased the utilisation of ANC and PNC services as well as shortened the time taken to reach an appropriate facility for delivery compared with standard care. BMJ Publishing Group 2019-05-13 /pmc/articles/PMC6528775/ /pubmed/31179030 http://dx.doi.org/10.1136/bmjgh-2018-001254 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Research Onono, Maricianah Atieno Wahome, Samuel Wekesa, Pauline Adhu, Catherine Kidiga Waguma, Lawrence Wandei Serem, Titus Owenga, Mildred Anyango Ong'wen, Patricia Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya |
title | Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya |
title_full | Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya |
title_fullStr | Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya |
title_full_unstemmed | Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya |
title_short | Effects of an expanded Uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in Homa Bay, Kenya |
title_sort | effects of an expanded uber-like transport system on access to and use of maternal and newborn health services: findings of a prospective cohort study in homa bay, kenya |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6528775/ https://www.ncbi.nlm.nih.gov/pubmed/31179030 http://dx.doi.org/10.1136/bmjgh-2018-001254 |
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