Factors associated with mobile phone usage to access maternal and child healthcare among women of urban slums in Dhaka, Bangladesh: a cross-sectional study

Abstract

IntroductionWith the acute shortage of human resources and infrastructure, mobile phones can be a critical tool for accessing health services and strengthening health systems in Bangladesh. Yet, there is a scarcity of evidence on the use of mobile phones in this context for accessing health services. In this study, we sought to explore the current use of mobile phones for accessing maternal and child healthcare and its determinants among recently delivered women in urban slums of Bangladesh.MethodsThe data were collected through interviewing 800 recently delivered women from eight slums of Dhaka city of Bangladesh during May and June 2018. The study followed a cross-sectional design and a two-stage cluster random sampling procedure was followed. A pretested structured questionnaire was employed to collect information. Chi square tests were performed for descriptive analyses and a multilevel binary logistic regression model was executed to explore the determinants of mobile phone usage for accessing maternal and childcare among the participants.ResultsOverall, 73.8% of study participants used mobile phones for accessing maternal and child healthcare. After adjusting for potential confounders, participants’ age, husband’s occupation, sex of household head, women’s ownership of mobile phones and household wealth status were found to be significantly associated with higher odds of using mobile phones to access maternal and child healthcare.ConclusionThe study highlighted the possibility of implementing large-scale mobile health (mHealth) interventions in slum settlements for accessing maternal and child healthcare and is a sustainable mitigation strategy for the acute health worker crisis in Bangladesh. The findings of this study are particularly crucial for policymakers and practitioners while they revise the health policy to incorporate mHealth interventions as highlighted in the recently initiated Digital Health Strategy of Bangladesh.

Exploring Factors Associated with Women’s Willingness to Provide Digital Fingerprints in Accessing Healthcare Services: A Cross-Sectional Study in Urban Slums of Bangladesh

“…Our study reports that the participants with small household sizes (<4) had a higher willingness to provide fingerprints for accessing healthcare services than those with large household sizes. This may be because women with increased household size are often overburdened with household chores and responsibilities [ 35 ], limiting them to seek appropriate and adequate healthcare services using digital fingerprints [ 11 ]. Similarly, a study in Dhaka’s slum areas indicated a decreased tendency among mothers to seek childcare services using fingerprints and mobile phones [ 24 ].…”

“…A two-stage cluster random sampling approach was employed to select 458 participants from Dhaka city’s eight randomly selected urban slums. The sample size calculation and the details of the study design can be found elsewhere [ 11 ].…”

“…In 2014, 13,938 slums were counted in Bangladesh [ 10 ]. Patient identification and verification remain highly challenging due to the volatile nature of the urban slums, their higher migration, slum evictions and the marginalization of destitute segments [ 11 ]. To overcome this situation, a more reliable and definitive form of identification, such as fingerprint biometrics, could help ensure that care is provided to the right people, leading to a safer and more effective healthcare system in resource-constrained settings [ 2 ].…”

“…To integrate mobile fingerprint scanners into the existing android mHealth app, used for health services via the Manoshi program in urban slums in 2007 [ 11 , 19 ], Building Resources Across Communities (BRAC) Bangladesh explored the potential of using Simprints’ low-cost fingerprint technology. Manoshi denotes mother, neonate, and child in Bengali.…”

“…Manoshi denotes mother, neonate, and child in Bengali. The intervention is a community-based essential healthcare package aimed at reducing morbidity and mortality among mothers, new-borns, and children residing in selected urban slums in Bangladesh by providing maternal and childcare services [ 11 ]. The intervention helps create demand for maternal and child healthcare services through behaviour change communication (BCC) and assists in accessing emergency obstetric care services by promoting effective referral linkages.…”