PRELIMINARY STUDIES: Focus group discussions and a community survey indicated that inadequate funds and transport caused delays in deciding to seek emergency obstetric care and in reaching facilities. INTERVENTIONS: Following improvements in the quality of obstetric services, a community loan program was established in early 1995. Community members determined its features: compulsory contributions; community administration; loans for obstetric complications only; no interest; a 6-month grace period; and 24-month repayment. A transport system was also established, in which private vehicle drivers agreed to respond to calls for emergency transport and charge a set fee. RESULTS: The equivalent of US $20,500 was collected from 81 annual and 2273 one-time contributors. Eighteen loans were approved in 9 months. Repayment data are not yet available. For the transport system, 23 drivers pledged permanent participation and 58 pledged to take part in 6-month rotations. They transported 18 women. COSTS: The cost of these interventions was $3409 for the loan fund and $2272 for the transport system. Sixty percent of the cost was paid by the community and the rest by the PMM project. CONCLUSIONS: Community-managed loan and transport systems for women with obstetric emergencies can be established and may contribute to reducing delay in obtaining emergency obstetric care.
PRELIMINARY STUDIES: Focus group discussions and a community survey indicated that inadequate funds and transport caused delays in deciding to seek emergency obstetric care and in reaching facilities. INTERVENTIONS: Following improvements in the quality of obstetric services, a community loan program was established in early 1995. Community members determined its features: compulsory contributions; community administration; loans for obstetric complications only; no interest; a 6-month grace period; and 24-month repayment. A transport system was also established, in which private vehicle drivers agreed to respond to calls for emergency transport and charge a set fee. RESULTS: The equivalent of US $20,500 was collected from 81 annual and 2273 one-time contributors. Eighteen loans were approved in 9 months. Repayment data are not yet available. For the transport system, 23 drivers pledged permanent participation and 58 pledged to take part in 6-month rotations. They transported 18 women. COSTS: The cost of these interventions was $3409 for the loan fund and $2272 for the transport system. Sixty percent of the cost was paid by the community and the rest by the PMM project. CONCLUSIONS: Community-managed loan and transport systems for women with obstetric emergencies can be established and may contribute to reducing delay in obtaining emergency obstetric care.
Authors: Joanna Morrison; Rita Thapa; Aman Sen; Rishi Neupane; Jo Borghi; Kirti Man Tumbahangphe; David Osrin; Dharma Manandhar; Anthony Costello Journal: Community Dev J Date: 2008-08-21
Authors: J Morrison; D Osrin; B Shrestha; K M Tumbahangphe; S Tamang; D Shrestha; S Thapa; N Mesko; D S Manandhar; A Costello Journal: J Perinatol Date: 2008-12 Impact factor: 2.521
Authors: Zulfiqar A Bhutta; Gary L Darmstadt; Rachel A Haws; Mohammad Yawar Yakoob; Joy E Lawn Journal: BMC Pregnancy Childbirth Date: 2009-05-07 Impact factor: 3.007
Authors: Anne C C Lee; Joy E Lawn; Simon Cousens; Vishwajeet Kumar; David Osrin; Zulfiqar A Bhutta; Steven N Wall; Allyala K Nandakumar; Uzma Syed; Gary L Darmstadt Journal: Int J Gynaecol Obstet Date: 2009-10 Impact factor: 3.561