Exploring new health markets: experiences from informal providers of transport for maternal health services in Eastern Uganda

BMC International Health and Human Rights

Research

David Serwadda¹  Elizabeth Ekirapa-Kiracho²  Chrispus Mayora²  George W Pariyo²  Olico Okui²  Freddie Ssengooba²  M Hafizur Rahman³  David H Peters³  Henry Lucas⁴  Gerald Bloom⁴ 

[1] Department of Disease Control and Environmental Health, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda;Department of Health Policy, Planning and Management, Makerere University School of Public Health, P.O. Box 7072, Kampala, Uganda;Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, 21205, Baltimore, MD, USA;Institute of Development Studies, at the University of Sussex, BN1 9RE, Brighton, UK;

关键词: Health Facility;    Focus Group Discussion;    Transport Service;    Maternal Health Service;    United States Dollar;   

DOI  :  10.1186/1472-698X-11-S1-S10

来源: Springer

【 摘 要 】

BackgroundAlthough a number of intermediate transport initiatives have been used in some developing countries, available evidence reveals a dearth of local knowledge on the effect of these rural informal transport mechanisms on access to maternal health care services, the cost of implementing such schemes and their scalability. This paper, attempts to provide insights into the functioning of the informal transport markets in facilitating access to maternal health care. It also demonstrates the role that higher institutions of learning can play in designing projects that can increase the utilization of maternal health services.ObjectivesTo explore the use of intermediate transport mechanisms to improve access to maternal health services, with emphasis on the benefits and unintended consequences of the transport scheme, as well as challenges in the implementation of the scheme.MethodsThis paper is based on the pilot phase to inform a quasi experimental study aimed at increasing access to maternal health services using demand and supply side incentives. The data collection for this paper included qualitative and quantitative methods that included focus group interviews, review of project documents and facility level data.ResultsThere was a marked increase in attendance of antenatal, and delivery care services, with the contracted transporters playing a leading role in mobilizing mothers to attend services. The project also had economic spill-over effects to the transport providers, their families and community generally. However, some challenges were faced including difficulty in setting prices for paying transporters, and poor enforcement of existing traffic regulations.Conclusions and implicationsThe findings indicate that locally existing resources such as motorcycle riders, also known as “boda boda” can be used innovatively to reduce challenges caused by geographical inaccessibility and a poor transport network with resultant increases in the utilization of maternal health services. However, care must be taken to mobilize the resources needed and to ensure that there is enforcement of laws that will ensure the safety of clients and the transport providers themselves.

【 授权许可】

Unknown   
© Pariyo et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.