A low-cost ultrasound program leads to increased antenatal clinic visits and attended deliveries at a health care clinic in rural Uganda

PLoS One. 2013 Oct 30;8(10):e78450. doi: 10.1371/journal.pone.0078450. eCollection 2013.

Abstract

Background: In June of 2010, an antenatal ultrasound program to perform basic screening for high-risk pregnancies was introduced at a community health care center in rural Uganda. Whether the addition of ultrasound scanning to antenatal visits at the health center would encourage or discourage potential patients was unknown. Our study sought to evaluate trends in the numbers of antenatal visits and deliveries at the clinic, pre- and post-introduction of antenatal ultrasound to determine what effect the presence of ultrasound at the clinic had on these metrics.

Methods and findings: Records at Nawanyago clinic were reviewed to obtain the number of antenatal visits and deliveries for the 42 months preceding the introduction of ultrasound and the 23 months following. The monthly mean deliveries and antenatal visits by category (first visit through fourth return visit) were compared pre- and post- ultrasound using a Kruskal-Wallis one-way ANOVA. Following the introduction of ultrasound, significant increases were seen in the number of mean monthly deliveries and antenatal visits. The mean number of monthly deliveries at the clinic increased by 17.0 (13.3-20.6, 95% CI) from a pre-ultrasound average of 28.4 to a post-ultrasound monthly average of 45.4. The number of deliveries at a comparison clinic remained flat over this same time period. The monthly mean number of antenatal visits increased by 97.4 (83.3-111.5, 95% CI) from a baseline monthly average of 133.5 to a post-ultrasound monthly mean of 231.0, with increases seen in all categories of antenatal visits.

Conclusions: The availability of a low-cost antenatal ultrasound program may assist progress towards Millennium Development Goal 5 by encouraging women in a rural environment to come to a health care facility for skilled antenatal care and delivery assistance instead of utilizing more traditional methods.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Ambulatory Care Facilities
  • Ambulatory Care*
  • Delivery of Health Care / methods*
  • Delivery, Obstetric / methods*
  • Female
  • Health Facilities
  • Humans
  • Patient Acceptance of Health Care
  • Pregnancy
  • Prenatal Care / methods*
  • Rural Population
  • Uganda
  • Ultrasonography / methods

Grant support

Funding for this study was provided by Imaging the World which received funding from the Fineberg Foundation, the Bill and Melinda Gates Foundation, Philips Health Care, McKesson Corporation, and Peervue Corporation. This research was also supported (in part) by an Alpha Omega Alpha postgraduate award. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.