Assessment of the impact of using call centertechnology to improve access and utilization of maternal and neonatal health services in Gombe State, Northeast, Nigeria

Abstract

The innovative strategy of call center technology and provision of mobile phone to frontline workerswerepart of strategiesintroduced by Society for Family Healthto provide health information,educate and referrals,toimprove uptake of maternal health services in Gombe state, Nigeria. According to Nigeria Demographic and Health Survey 2013 put the proportion of women with antenatal care from a skilled provider at 58.2 percentand health facility delivery at 27.6 percent. Thispaper presents assessment of the impact of using call center technology to increase uptake of maternal health services. Focus group discussions and in-depth interviewswere explored to elicit information from 270 recipients of call center, stakeholders and call center agents in six local government areas in the state.Moderators and note-takers were trained on the art of moderating focus group discussion to elicit information from the participants and the discussions were tape-recorded. Manual content analysis was conducted using tape-recorded transcripts, moderators’ keynotes and notes taken during the FGDs and in-depth interviews. Majority of the participants reported of having heard about the call center and knowledge levels were similar in both urban and rural areas. A slightly below average of the participants claimed to have had contacts with call center to obtain health information on management of pregnancyrelated complications.And virtually all mothers that had used call center reported of having had antenatal care visits;facility delivery and postnatal check-up and this has led to reduction in morbidity and maternal mortality.Notwithstanding, the study revealed some challenges that negatively impacted the low utilization of call center services. One major challenge notedwas the concept of “stranger” tagged on call center agents, andwomen refused to talk to the agents. Lack of ownership of phone, poor connectivity, delayed in picking calls, attitude,and confidentiality issues were other challenges mentioned. Awareness creation, face-to-face interaction, radio jingles and advocacy to community traditional/religious leaderscan address issue of “stranger”;re-training and motivation of call center agents will address attitudes,client-agents relations and delay in picking calls; thereby increase center utilization.