Increasing Access to Maternal-Newborn Health Services

 
 

Women who are pregnant, in labor or post-partum are especially affected by the lack of adequate and affordable transportation in rural Uganda. Almost 95% of pregnant women live at least 5 kilometers from the nearest health facility, and public transportation options are limited. With the exception of the one paved road that connects Rakai to Masaka, all others are dirt roads. During rainy season, already poor roads may be washed away or become impassable. Just two ambulances serve the district’s 518,000 people.

With support of Dining for Women and Spring Together Foundation, we will launch the Mama Rescue Project, which will link local motorcycle and automobile taxi drivers with women in labor, providing lifesaving transport to health center and hospital. Mama Rescue was previously piloted and operated effectively from March 2015 until December 2017, serving 14 health centers and 2 referral hospitals in Kasese District of western Uganda.

 

Mama Rescue: How it works

Step 1: Facility-Based Delivery: Mama Rescue will provide transport vouchers to women enrolled in the system after attending their fourth antenatal visit. These vouchers will guarantee them free transport by boda boda (motorcycle taxi) from home to a health center at the time of delivery with a skilled midwife.

Step 2: Rapid Emergency Response: Midwives at health centers will use their simple mobile phones to request emergency transport, using an automatic dispatch USSD-based system (Unstructured Supplementary Service Data). Local taxi drivers will be alerted by mobile phone text and a driver with boda boda is selected based on the quickest response time. Upon transporting the woman to the receiving facility, the midwife will verify the driver immediately and initiate payment with mobile money for the transport service rendered. Additionally, automobile taxis will be enrolled as well to serve as ‘ambulances’ when emergency referral from health center to hospital is required and a proper ambulance is not available.

 

Step 3: Communication of Critical Information: Referring midwives will use the Mama Rescue menus on their phones to send summary clinical information to the hospital, ahead of the woman’s arrival. This enables the hospital midwives and physicians to prepare for the admission and reduce the wait time for services such as surgical procedures and blood transfusions.