Giving cell phones to pregnant women and improving services may increase primary health facility utilization: a case-control study of a Nigerian project.
BACKGROUND
Worldwide, about 287 000 women die each year from mostly preventable complications related to pregnancy and childbirth. A disproportionately high number of these deaths occur in sub-Saharan Africa. The Abiye ('Safe Motherhood') project in the Ifedore Local Government Area (LGA) of Ondo-State of Nigeria aimed at improving facility utilization and maternal health through the use of cell phones and generally improved health care services for pregnant women, including Health Rangers, renovated Health Centres, and improved means of transportation.


METHODS
A one-year sample of retrospective data was collected from hospital records and patients' case files from Ifedore (the project area) and Idanre (control area) and was analyzed to determine healthcare facility utilization rates in each location. Semi-structured questionnaires were used to generate supplemental data.


RESULTS
The total facility utilization rate of pregnant women was significantly higher in Ifedore than in Idanre. The facility utilization rate of the primary health care centres was significantly higher in Ifedore than in Idanre. The number of recorded cases of the five major causes of maternal death in the two LGAs was not significantly different, possibly because the project was new.


CONCLUSIONS
Giving cell phones to pregnant women and generally improving services could increase their utilization of the primary healthcare system.
Sunday Oluwafemi
SO
Oyeyemi
Department of Clinical Medicine, University of Tromsø, UNN-Asgard, N-9291 Tromsø, Norway. rolf.wynn@gmail.com.
Rolf
R
Wynn
D000328:Adult; D016022:Case-Control Studies; D040421:Cell Phone; D005260:Female; D006297:Health Services Accessibility; D006302:Health Services Research; D006801:Humans; D009549:Nigeria; D010342:Patient Acceptance of Health Care; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies