Mobility for maternal health among women in hard-to-reach fishing communities on Lake Victoria, Uganda; a community-based cross-sectional survey
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Date
2021
Journal Title
Journal ISSN
Volume Title
Publisher
BMC health services research
Abstract
Maternal mortality is still a challenge in Uganda, at 336 deaths per 100,000 live births, especially in
rural hard to reach communities. Distance to a health facility influences maternal deaths. We explored women’s
mobility for maternal health, distances travelled for antenatal care (ANC) and childbirth among hard-to-reach Lake
Victoria islands fishing communities (FCs) of Kalangala district, Uganda.
Methods: A cross sectional survey among 450 consenting women aged 15–49 years, with a prior childbirth was
conducted in 6 islands FCs, during January-May 2018. Data was collected on socio-demographics, ANC, birth
attendance, and distances travelled from residence to ANC or childbirth during the most recent childbirth.
Regression modeling was used to determine factors associated with over 5 km travel distance and mobility for
childbirth.
Results: The majority of women were residing in communities with a government (public) health facility [84.2 %,
(379/450)]. Most ANC was at facilities within 5 km distance [72 %, (157/218)], while most women had travelled
outside their communities for childbirth [58.9 %, (265/450)]. The longest distance travelled was 257.5 km for ANC
and 426 km for childbirth attendance.
Travel of over 5 km for childbirth was associated with adolescent girls and young women (AGYW) [AOR = 1.9, 95 %
CI (1.1–3.6)], up to five years residency duration [AOR = 1.8, 95 % CI (1.0-3.3)], and absence of a public health facility
in the community [AOR = 6.1, 95 % CI (1.4–27.1)].
Women who had stayed in the communities for up to 5 years [AOR = 3.0, 95 % CI (1.3–6.7)], those whose partners
had completed at least eight years of formal education [AOR = 2.2, 95 % CI (1.0-4.7)], and those with up to one
lifetime birth [AOR = 6.0, 95 % CI (2.0-18.1)] were likely to have moved to away from their communities for
childbirth. Conclusions: Despite most women who attended ANC doing so within their communities, we observed that
majority chose to give birth outside their communities. Longer travel distances were more likely among AGYW,
among shorter term community residents and where public health facilities were absent.
Description
Keywords
Mobility, Distance, Childbirth, Women, Island, Fishing, Communities, Uganda
Citation
Ssetaala, A., Ssempiira, J., Nanyonjo, G., Okech, B., Chinyenze, K., Bagaya, B., ... & Degomme, O. (2021). Mobility for maternal health among women in hard-to-reach fishing communities on Lake Victoria, Uganda; a community-based cross-sectional survey. BMC health services research, 21(1), 1-11. https://doi.org/10.1186/s12913-021-06973-5