Experiences of using the toll-free telephone line to access maternal and newborn health services in central Uganda: a qualitative study

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Study Justification:
– The study aimed to explore the experiences of health workers and community members in using the toll-free telephone line (TFL) to access maternal and newborn health services in central Uganda.
– The TFL service is influential in addressing the first and second delays in seeking care, connecting vulnerable mothers to health facilities at no cost.
– Understanding the experiences and challenges of using the TFL can help improve its effectiveness and impact in addressing maternal and newborn health issues.
Study Highlights:
– The TFL service improved health worker and community relations.
– It provided timely health advice and facilitated prompt response to obstetric emergencies.
– The TFL enabled timely referrals and linkage of vulnerable mothers to health facilities.
Study Recommendations:
– Increase investment and scale up of high-impact mHealth interventions like the TFL service.
– Address the challenges faced by the TFL service, such as unanswered calls, language differences, poor connectivity/network, and misuse/abuse.
– Strengthen the TFL service to ensure its continued effectiveness in addressing the first and second delays in seeking care.
Key Role Players:
– Health workers: They play a crucial role in using and promoting the TFL service to connect vulnerable mothers to health facilities.
– Community members: Their experiences and feedback are important in improving the TFL service.
– Save the Mothers (STM): The organization operating the TFL service needs to be involved in addressing the recommendations and ensuring the service’s sustainability.
Cost Items for Planning Recommendations:
– Infrastructure: Investment in improving connectivity and network infrastructure to address the challenges faced by the TFL service.
– Training: Providing training to health workers and community members on the effective use of the TFL service.
– Monitoring and Evaluation: Allocating resources for monitoring and evaluating the impact and effectiveness of the TFL service.
– Public Awareness Campaigns: Budgeting for campaigns to raise awareness about the TFL service and its benefits to encourage its utilization.
Please note that the cost items provided are general suggestions and may vary based on the specific context and requirements of the TFL service.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study used a qualitative design and collected data through focus group discussions, which allows for in-depth exploration of experiences. The use of audio recordings and verbatim transcription adds to the credibility of the findings. However, the study was conducted in only four health facilities, which limits the generalizability of the results. To improve the strength of the evidence, future studies could include a larger sample size and a more diverse range of health facilities in different regions of Uganda.

Objectives: Save the Mothers (STM) operates the toll-free telephone line (TFL) service in nine health facilities in Uganda. The TFL is influential in addressing the first and second delays in seeking care as it connects vulnerable mothers to health facilities at no cost. This study aimed at exploring the experiences of health workers and community members in using the TFL to access maternal and newborn health services in four health facilities in central Uganda. Study design: This phenomenological/qualitative study used focus group discussions (FGDs) to collect data in four health facilities. Methods: A total of 10 FGDs were conducted; two with health workers, four with women, and another four with both men and women. Each session lasted 45–60 min and had a moderator, observer, and note taker. All discussions were audio-recorded after obtaining consent from the participants. Interviews were transcribed verbatim and translated to English from audio recordings. Data analysis was performed using the thematic analysis using QDA DATA Miner software. Results: The TFL service was pivotal in improving health worker and community relations, relaying timely health advice, ensuring prompt response to obstetric emergencies and facilitated timely referrals. However, the service faced several obstacles: unanswered calls, language differences, poor connectivity/network, and misuse/abuse. Conclusion: This study demonstrates the potential of the TFL service in addressing the first and second delay as it allows for timely linkage of vulnerable mothers to health facilities. The TFL enhanced health worker and community relations and facilitated timely referrals and relaying of health advice. Addressing maternal mortality in low-income settings necessitates increased investment and scale up of such high-impact mHealth interventions.

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The study “Experiences of using the toll-free telephone line to access maternal and newborn health services in central Uganda: a qualitative study” recommends investing in and scaling up high-impact mHealth interventions like the toll-free telephone line (TFL) service to improve access to maternal health.

The TFL service, operated by Save the Mothers (STM) in nine health facilities in Uganda, has proven to be effective in addressing the first and second delays in seeking care for vulnerable mothers. It allows them to connect with health facilities at no cost, enabling timely access to maternal and newborn health services.

The study found that the TFL service improved relations between health workers and the community, facilitated timely referrals, and provided prompt responses to obstetric emergencies. However, there were challenges such as unanswered calls, language differences, poor connectivity/network, and misuse/abuse of the service.

To overcome these obstacles and further enhance access to maternal health, the study recommends investing in improving the infrastructure and connectivity for the TFL service. This could involve strengthening network coverage, ensuring language support, and addressing technical issues to ensure reliable and efficient communication.

Additionally, training and capacity building programs can be implemented for health workers and community members to effectively utilize and promote the TFL service. This would maximize its potential and ensure its proper use for timely access to maternal and newborn health services.

Overall, the study highlights the potential of mHealth interventions like the TFL service in addressing maternal mortality in low-income settings. By investing in and scaling up such high-impact interventions, access to maternal health can be significantly improved, leading to better health outcomes for vulnerable mothers and newborns.
AI Innovations Description
The recommendation to improve access to maternal health based on the study “Experiences of using the toll-free telephone line to access maternal and newborn health services in central Uganda: a qualitative study” is to invest in and scale up high-impact mHealth interventions like the toll-free telephone line (TFL) service.

The TFL service, operated by Save the Mothers (STM) in nine health facilities in Uganda, has shown to be influential in addressing the first and second delays in seeking care for vulnerable mothers. It connects them to health facilities at no cost, allowing for timely linkage and access to maternal and newborn health services.

The study found that the TFL service improved health worker and community relations, facilitated timely referrals, and provided prompt response to obstetric emergencies. However, there were challenges such as unanswered calls, language differences, poor connectivity/network, and misuse/abuse of the service.

To overcome these obstacles and further enhance access to maternal health, it is recommended to invest in improving the infrastructure and connectivity for the TFL service. This could involve strengthening the network coverage, ensuring language support, and addressing technical issues to ensure reliable and efficient communication.

Additionally, training and capacity building programs can be implemented for health workers and community members to effectively utilize and promote the TFL service. This would help in maximizing its potential and ensuring its proper use for timely access to maternal and newborn health services.

Overall, the study highlights the potential of mHealth interventions like the TFL service in addressing maternal mortality in low-income settings. By investing in and scaling up such high-impact interventions, access to maternal health can be significantly improved, leading to better health outcomes for vulnerable mothers and newborns.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health based on the abstract, the following methodology can be used:

1. Identify the target population: Determine the specific population that will be the focus of the simulation, such as vulnerable mothers in low-income settings in Uganda.

2. Define the intervention: Clearly outline the intervention being simulated, which in this case is the investment and scaling up of the toll-free telephone line (TFL) service operated by Save the Mothers (STM) in Uganda.

3. Establish the baseline: Collect data on the current state of access to maternal health in the target population. This can include indicators such as maternal mortality rates, delays in seeking care, and utilization of maternal health services.

4. Determine the parameters: Identify the specific parameters that will be used to measure the impact of the intervention. This can include indicators such as the number of calls made to the TFL service, the response time for obstetric emergencies, and the number of timely referrals facilitated.

5. Collect data: Conduct surveys, interviews, or other data collection methods to gather information on the target population’s awareness, utilization, and satisfaction with the TFL service. This can be done through questionnaires, focus group discussions, or interviews with both health workers and community members.

6. Analyze the data: Use appropriate statistical methods to analyze the collected data and determine the impact of the TFL service on improving access to maternal health. This can involve comparing the baseline data with the data collected after the intervention to measure changes in maternal health outcomes and service utilization.

7. Interpret the results: Interpret the findings of the analysis to understand the extent to which the investment and scaling up of the TFL service has improved access to maternal health. This can include quantifying the reduction in delays in seeking care, improvements in health worker and community relations, and increased utilization of maternal health services.

8. Draw conclusions and make recommendations: Based on the results of the simulation, draw conclusions about the effectiveness of the TFL service and its impact on improving access to maternal health. Make recommendations for further investment and scaling up of mHealth interventions like the TFL service, taking into account the challenges identified in the study (unanswered calls, language differences, poor connectivity/network, and misuse/abuse).

9. Communicate the findings: Present the findings of the simulation in a clear and concise manner, highlighting the impact of the TFL service on improving access to maternal health. Share the recommendations with relevant stakeholders, such as policymakers, healthcare providers, and organizations involved in maternal health initiatives.

10. Monitor and evaluate: Continuously monitor and evaluate the implementation of the recommendations to assess their long-term impact on improving access to maternal health. Adjust the intervention and strategies as needed based on ongoing monitoring and evaluation efforts.

By following this methodology, researchers and policymakers can gain insights into the potential impact of investing in and scaling up mHealth interventions like the toll-free telephone line service on improving access to maternal health in low-income settings.

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