Imagine not being able to call 911 in an emergency. Most of us rarely (if ever) use the 911 service that is widely available in North America, but we find comfort knowing that it is an option. When we are scared or in crisis, we can call someone who will know what to do, who has the ability to help.
There is no 911 in East Africa. But a few years ago, Save the Mothers piloted a Toll Free Line service at several of our Mother Baby Friendly Hospitals designed to function in much the same way.
Save the Mothers funds the service, allowing any community member with access to a phone (and over 90% of the Ugandan population have phones) to call their local health facility at zero cost to them. Once connected, they can speak directly to a midwife/health worker in the maternity ward.
The Toll Free Lines project came in stages, with four health facilities piloting the project. First, we sensitized and trained staff at the health facilities on using the service, sharing the benefits of taking the calls. Workers were taught that when a potential patient called before making the journey to the hospital, they could either put the caller’s mind at ease, explaining that such a trip was not needed, or they could prepare for an incoming complicated case.
Next, we informed the community about the service. Community Drive outreaches allowed the team from Save the Mothers and each of our pilot locations to speak to members of the community about how to use the service. The free number was handed out, speaking to community members, radio announcements were made and promotional stickers were placed throughout the catchment areas, on shop doors, food stands, taxi stands, etc.
Recently, we undertook a study (funded through a grant awarded by Uganda Christian University, and led by the Global Health Corps fellows) to look into the numbers, and the people behind the Toll-Free Line service.
While Toll Free Lines exist in 9 of the 10 Mother Baby Friendly Hospitals, the study focussed on four health facilities.
After tracking the trends of calls for some months, we recognized that there was a need for greater outreach into the communities to let people know about the service.
After some consideration, the team concluded the best place to connect with mothers and pregnant women is antenatal [prenatal] clinics. Each woman who attends an antenatal appointment is given a passbook – where her personal information is recorded to document her pregnancy, and notes are made regarding any challenges or concerns. Stickers were created with the Toll-Free Numbers to place inside these government-published books at our four facilities.
With this intervention, we saw an increase in the numbers of calls being made to each of the facilities.