Outreach, portable ultrasound, and radio – a novel method of improving antenatal turnout and maternal/child health in rural Uganda
Bibliographic record
Abstract
Purpose Uganda currently has the 20th highest rate of maternal mortality in the world. A large portion of its rural communities are isolated due to mountainous topography, lack adequate access to healthcare, commonly deliver at home and are mistrustful of modern medicine. Methods A clustered randomized controlled trial was conducted by a Canadian medical and dental not for profit corporation in partnership with a Ugandan not for profit non-governmental community development organization to determine the efficacy of free portable ultrasound (pOBU), in conjunction with a structured maternal health clinic (sMHC), in improving antenatal care (ANC) attendance in rural Uganda. Patients in the first four clusters were blinded to the presence of ultrasound and informed about the sMHC by community contacts, in the fifth cluster patients were informed about the sMHC as well as pOBU through community contacts, in the sixth cluster patients were informed about the sMHC by community contacts and radio announcement, and in the seventh and eighth clusters patients were informed about the sMHC and pOBU through community contacts and radio announcements. Each cluster rotated through registration, pre-test counseling for HIV, routine ANC testing, family planning, pOBU and, for the women identified as being high risk by triage, dental and/or medical services. Results In total 158 women presented to ANC over eight clusters. The first four clusters had an attendance of 59 patients, while the last two had an attendance of 76. Only 7 women attended clinic when sMHC was advertised via radio with no mention of pOBU. Discussion: By creating a sMHC centered around a pOBU women who typically deliver at home and are hesitant to engage in modern medicine were successfully encouraged to seek medical care during pregnancy. These women all received invaluable prenatal care in addition to receiving a pOBU. Barriers to health and education were broken down through community partnership and innovative health care strategies. Conclusion By providing a stimulus for pregnant women to seek out health care providers it will be possible to move towards EMTCT, encourage delivery at hospital, and build trust and understanding between the rural Ugandan population and the national healthcare system. This strategy is easily up scalable and implementable across a wide range of rural landscapes. Key messages Providing free portable ultrasound and advertising the incentive via radio in rural Uganda nearly tripples uptake of antenatal care. The free portable utrasound entices women in the most at risk categories (low education, typically delivery at home, and never having seen a healthcare provider in pregnancy) to come for screening.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".