scholarly journals A Mobile Health Wallet for Pregnancy-Related Health Care in Madagascar: Mixed-Methods Study on Opportunities and Challenges (Preprint)

2018 ◽  
Author(s):  
Nadine Muller ◽  
Peter Martin Ferdinand Emmrich ◽  
Elsa Niritiana Rajemison ◽  
Jan-Walter De Neve ◽  
Till Bärnighausen ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Mobile Phone ◽  
Mobile Health ◽  
Maternal Health Care ◽  
Ease Of Use ◽  
Communication Strategy ◽  
Financial Barriers ◽  
Out Of Pocket Payments ◽  
Skilled Health

BACKGROUND Mobile savings and payment systems have been widely adopted to store money and pay for a variety of services, including health care. However, the possible implications of these technologies on financing and payment for maternal health care services—which commonly require large 1-time out-of-pocket payments—have not yet been systematically assessed in low-resource settings. OBJECTIVE The aim of this study was to determine the structural, contextual, and experiential characteristics of a mobile phone–based savings and payment platform, the Mobile Health Wallet (MHW), for skilled health care during pregnancy among women in Madagascar. METHODS We used a 2-stage cluster random sampling scheme to select a representative sample of women utilizing either routine antenatal (ANC) or routine postnatal care (PNC) in public sector health facilities in 2 of 8 urban and peri-urban districts of Antananarivo, Madagascar (Atsimondrano and Renivohitra districts). In a quantitative structured survey among 412 randomly selected women attending ANC or PNC, we identified saving habits, mobile phone use, media consumptions, and perception of an MHW with both savings and payment functions. To confirm and explain the quantitative results, we used qualitative data from 6 semistructured focus group discussions (24 participants in total) in the same population. RESULTS 59.3% (243/410, 95% CI 54.5-64.1) saved toward the expected costs of delivery and, out of those, 64.4% (159/247, 95% CI 58.6-70.2) used household cash savings for this purpose. A total of 80.3% (331/412, 95% CI 76.5-84.1) had access to a personal or family phone and 35.7% (147/412, 95% CI 31.1-40.3) previously used Mobile Money services. Access to skilled health care during pregnancy was primarily limited because of financial obstacles such as saving difficulties or unpredictability of costs. Another key barrier was the lack of information about health benefits or availability of services. The general concept of an MHW for saving toward and payment of pregnancy-related care, including the restriction of payments, was perceived as beneficial and practicable by the majority of participants. In the discussions, several themes pointed to opportunities for ensuring the success of an MHW through design features: (1) intuitive technical ease of use, (2) clear communication and information about benefits and restrictions, and (3) availability of personal customer support. CONCLUSIONS Financial obstacles are a major cause of limited access to skilled maternal health care in Madagascar. An MHW for skilled health care during pregnancy was perceived as a useful and desirable tool to reduce financial barriers among women in urban Madagascar. The design of this tool and the communication strategy will likely be the key to success. Particularly important dimensions of design include technical user friendliness and accessible and personal customer service.

scholarly journals Women Using Mobile Phones for Health Communication Are More Likely to Use Prenatal and Postnatal Services in Bangladesh: Cross-Sectional Study (Preprint)

2018 ◽  
Author(s):  
Shangfeng Tang ◽  
Bishwajit Ghose ◽  
Md Rakibul Hoque ◽  
Gang Hao ◽  
Sanni Yaya
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Mobile Phone ◽  
Mobile Phones ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Cross Sectional ◽  
Mobile Phone Use ◽  
Delivery Services

BACKGROUND The public health system in Bangladesh has been struggling to provide coverage and utilization of basic maternal health care services in pursuit of achieving maternal and child mortality-related goals. Interestingly, the rapid popularization of mobile technology in the country is transforming the landscape of health care access and delivery. However, little is known regarding the use of mobile phones from the perspective of maternal health care service utilization. OBJECTIVE In this study, we aimed to investigate the prevalence and sociodemographic pattern of mobile phone use for health services among women and relationship between the use of mobile phone use and the uptake of essential maternal health services (MHSs). METHODS Cross-sectional data from the Bangladesh Demographic and Health Survey on 4494 mothers aged between 15 and 39 years were used in the analysis. Using mobile phones to get health services or advice was hypothesized to have a positive association with the uptake of basic MHSs (antenatal care, ANC, facility delivery services, postnatal care) and postnatal care for the newborn. Data were analyzed using bivariate and multivariable techniques. RESULTS More than a quarter (1276/4494, 28.4%; 95% CI 26.8-30.3) of the women aged 15-39 years reported using mobile phones to get health services with significant sociodemographic variations in the use of mobile phones. Analysis of the specific purposes revealed that, in most cases, mobile phones were used to contact service providers and consult with the same about what to do, whereas a smaller proportion reported using mobile phone for the purposes of arranging money and transportation. Multivariable analysis showed that compared with respondents who reported not using mobile phones for health care services, those who used them had higher odds of making 3+ ANC visits and delivering at a health facility. The odds were slightly higher for rural residents than for those in the urban areas. CONCLUSIONS The findings of this study conclude that women who use mobile phones are more likely to use ANC and professional delivery services than those who do not. More in-depth studies are necessary to understand the mechanism through which mobile phone-based services enhance the uptake of maternal health care.

scholarly journals Out-of-pocket payments in the context of a free maternal health care policy in Burkina Faso: a national cross-sectional survey

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ivlabèhiré Bertrand Meda ◽  
Adama Baguiya ◽  
Valéry Ridde ◽  
Henri Gautier Ouédraogo ◽  
Alexandre Dumont ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Burkina Faso ◽  
Health Care Policy ◽  
Maternal Health Care ◽  
Care Policy ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Out Of Pocket Payments

scholarly journals Socio-cultural contextual factors that contribute to the uptake of a mobile health intervention to enhance maternal health care in rural Senegal

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Margaret E. MacDonald ◽  
Gorgui Sene Diallo
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Community Health ◽  
Health Care Providers ◽  
Mobile Health ◽  
Maternal Health Care ◽  
Care Group ◽  
Care Providers ◽  
Mhealth Intervention

Abstract Background Although considerable progress has been made in reducing maternal mortality over the past 25 years in Senegal, the national maternal mortality ratio (MMR), at 315 deaths per 100,000 live births, is still unacceptably high. In recent years a mobile health (mHealth) intervention to enhance maternal health care has been introduced in rural and remote areas of the country. CommCare is an application that runs on cell phones distributed to community health workers known as matrones who enroll and track women throughout pregnancy, birth and the post-partum, offering health information, moral support, appointment reminders, and referrals to formal health care providers. Methods An ethnographic study of the CommCare intervention and the larger maternal health program into which it fits was conducted in order to identify key social and cultural contextual factors that contribute to the uptake and functioning of this mHealth intervention in Senegal. Ethnographic methods and semi-structured interviews were used with participants drawn from four categories: NGO field staff (n = 16), trained health care providers (including physicians, nurses, and midwives) (n = 19), community level health care providers (n = 13); and women belonging to a community intervention known as the Care Group (n = 14). Data were analyzed using interpretive analysis informed by critical medical anthropology theory. Results The study identified five socio-cultural factors that work in concert to encourage the uptake and use of CommCare: convening women in the community Care Group; a cultural mechanism for enabling pregnancy disclosure; constituting authoritative knowledge amongst women; harnessing the roles of older women; and adding value to community health worker roles. We argue that, while CommCare is a powerful tool of information, clinical support, surveillance, and data collection, it is also a social technology that connects and motivates people, transforming relationships in ways that can optimize its potential to improve maternal health care. Conclusions In Senegal, mHealth has the potential not only to bridge the gaps of distance and expertise, but to engage local people productively in the goal of enhancing maternal health care. Successful mHealth interventions do not work as ‘magic bullets’ but are part of ‘assemblages’ – people and things that are brought together to accomplish particular goals. Attention to the social and cultural elements of the global health assemblage within which CommCare functions is critically important to understand and develop this mHealth technology to its full potential.

scholarly journals Improving access to safe delivery for poor women by voucher scheme in Bangladesh

2015 ◽  
Vol 5 (1) ◽  
pp. 39-43
Author(s):  
Akkur Chandra Das
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Maternal Health Care ◽  
Delivery Care ◽  
Voucher Scheme ◽  
Cross Sectional ◽  
Financial Barriers ◽  
Safe Delivery ◽  
Care Services ◽  
Birth Attendance

Maternal and child mortality are still higher in Bangladesh where delivery care services are associated with a number of problems. Demand-side financing, popularly well-known as maternal health care voucher, is found to reduce the financial barriers, increases choice for clients, and improves efficiency in delivery and quality of services which ultimately enhances maternal health. A cross-sectional study was conducted in different upzilas of Bhola district in Bangladesh among poor married women and found that voucher scheme receivers were 17.64 times more likely to receive delivery care services than respondents who were not part of the voucher scheme. On the other hand, the study pointed out that recipients of the voucher scheme received comparatively higher levels of delivery care services compared to those not in the voucher scheme, such as skilled birth attendance (64.2% vs. 26.3%), institutional delivery services (86.9% vs. 24.7%), and transport costs (92.5% vs. 23.1%). As the voucher scheme receivers’ delivery care services ensured better health status and care services than non-voucher scheme receivers in Bangladesh, the current study suggests that increasing the accessibility of voucher scheme programs will facilitate the provision of effective maternal health care services.South East Asia Journal of Public Health Vol.5(1) 2015: 39-43

scholarly journals Correction to: Inequalities in the utilisation of maternal health Care in Rural India: Evidences from National Family Health Survey III & IV

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Balhasan Ali ◽  
Shekhar Chauhan
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Survey ◽  
Family Health ◽  
Maternal Health Care ◽  
Rural India ◽  
National Family Health Survey ◽  
National Family

An amendment to this paper has been published and can be accessed via the original article.

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