title: A low-cost ultrasound program leads to increased antenatal clinic visits and attended deliveries at a health care clinic in rural Uganda.
abstract: BACKGROUND
  In June of 2010, an antenatal ultrasound program to perform basic screening for high-risk pregnancies was introduced at a community health care center in rural Uganda. Whether the addition of ultrasound scanning to antenatal visits at the health center would encourage or discourage potential patients was unknown. Our study sought to evaluate trends in the numbers of antenatal visits and deliveries at the clinic, pre- and post-introduction of antenatal ultrasound to determine what effect the presence of ultrasound at the clinic had on these metrics.
  
  
  RESULTS
  Records at Nawanyago clinic were reviewed to obtain the number of antenatal visits and deliveries for the 42 months preceding the introduction of ultrasound and the 23 months following. The monthly mean deliveries and antenatal visits by category (first visit through fourth return visit) were compared pre- and post- ultrasound using a Kruskal-Wallis one-way ANOVA. Following the introduction of ultrasound, significant increases were seen in the number of mean monthly deliveries and antenatal visits. The mean number of monthly deliveries at the clinic increased by 17.0 (13.3-20.6, 95% CI) from a pre-ultrasound average of 28.4 to a post-ultrasound monthly average of 45.4. The number of deliveries at a comparison clinic remained flat over this same time period. The monthly mean number of antenatal visits increased by 97.4 (83.3-111.5, 95% CI) from a baseline monthly average of 133.5 to a post-ultrasound monthly mean of 231.0, with increases seen in all categories of antenatal visits.
  
  
  CONCLUSIONS
  The availability of a low-cost antenatal ultrasound program may assist progress towards Millennium Development Goal 5 by encouraging women in a rural environment to come to a health care facility for skilled antenatal care and delivery assistance instead of utilizing more traditional methods.
authors.affiliation: Department of Radiology, University of Vermont College of Medicine, Fletcher Allen Health Care, Burlington, Vermont, United States of America.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Ross
authors.forename: Kristen K
authors.initials: KK
authors.lastname: DeStigter
authors.forename: Matthew
authors.initials: M
authors.lastname: Rielly
authors.forename: Sonia
authors.initials: S
authors.lastname: Souza
authors.forename: Gabriel Eli
authors.initials: GE
authors.lastname: Morey
authors.forename: Melissa
authors.initials: M
authors.lastname: Nelson
authors.forename: Eric Z
authors.initials: EZ
authors.lastname: Silfen
authors.forename: Brian
authors.initials: B
authors.lastname: Garra
authors.forename: Alphonsus
authors.initials: A
authors.lastname: Matovu
authors.forename: Michael Grace
authors.initials: MG
authors.lastname: Kawooya
mesh_terms: D000553:Ambulatory Care; D000554:Ambulatory Care Facilities; D003695:Delivery of Health Care / Q000379:methods*; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006268:Health Facilities; D006801:Humans; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D012424:Rural Population; D014454:Uganda; D014463:Ultrasonography / Q000379:methods