Effect of Training “Boda-boda” Riders on Community-Based Referrals for Maternal Outcome: A Case of Busoga Region, Uganda

Abstract

Many pregnant mothers miss antenatal care attendance and health facility deliveries despite several interventions either due to knowledge gap on the benefits or lack of transport means to reach the health centre. Therefore, training of “boda-boda” (motor-cycle) riders in Busoga Region in Uganda was conducted to determine its effect on health facility-based deliveries. The study was a non-randomized control trial with intervention and control groups from selected health centers and communities in Busoga Region. Interventions included the training of boda-boda riders for 5 days to give them knowledge; with a six months follow-up to determine the impact of training. Questionnaires, interviews and focus group discussions were used to collect quantitative and qualitative data. Descriptive statistical analysis was computed for the quantitative data and thematic analysis for qualitative data. Findings revealed improved knowledge of boda-boda riders on maternal referrals from 49.1% to 79.0% in the intervention arm compared to 43.8% to 45.2% in the control arm. Use of boda-boda transport by mothers improved from 0% to 70.5% in the intervention arm compared to only 0% to 51.2% in the control arm. Also, of the 70.5% of the mothers who used boda-boda transport, 69.4% were transported by trained boda-boda riders and only 30.6% by un-trained boda-boda riders. Apart from age (p=0.000; CI=2.785 – 53.284) and ownership of the motorcycle (p=0.002; CI=0.992 – 8.658), the rest of the socio-demographic determinants of health facility-based deliveries were not statistically significant. Age of boda-boda riders (25–34 years, p=0.000) and ownership of the play a pivotal role in the improvement of health facility-based deliveries. Training of boda-boda riders and other key stakeholders impacted on the community based maternal referrals in the study area.