A Multi-Method Study on the Impact of Transport Systems in Maternal and Newborn Health in Nampula Province-Mozambique

Abstract

Background & Objectives: Motorcycle ambulances have proven to be effective in similar context LIC, such as Mozambique. Although these services are not new in the country, there are no registered records of the outcomes of motorcycle ambulance services in the Mozambican context. This study aims to understand the implementation considerations of motorcycle ambulance aimed at maternal and new-born health in Nampula province - Mozambique. Methods: A two-phase exploratory sequential mixed methods design. Semi-structured qualitative interviews were conducted on community members from the Natikiri district; nurses from the Marrere General Hospital maternal and child health services; decision-makers in the same Hospital and the Provincial Health Department in Nampula from March to July 2020. The second phase consisted of collecting and analysing the costs of the motorcycle ambulances per capita of women in reproductive age in the same district. Results: focus group discussion and key-informant interviews were conducted on 52 people. Although the intervention was viable and acceptable, sustainability was predominantly negative without the support of the ACPH project. The intervention cost 47.55CAD per year for three communities and 5.94CAD per trip for the motorcycle ambulance maintenance. Conclusion: Motorcycle ambulances have proven to be effective in reducing the first barriers women encounter in access to early healthcare. Community-based transport system greatly influence success in the improvement of maternal and newborn healthcare. Challenges with the costs and sustainability of the system were to be expected, but with a strong collaboration from the public health sector, these can be reduced and even overcome.