Andrew Ross, et al., “A Low-Cost Ultrasound Program Leads to Increased Antenatal Clinic Visits and Attended Deliveries at a Health Care Clinic in Rural Uganda,” PLoS ONE 8, no. 10 (October 30, 2013)

URL: www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0078450

Abstract

Background: In June of 2010, an antenatal ultrasound program to perform basic screening for high-risk pregnancies was introduced at a community health care center in rural Uganda. Whether the addition of ultrasound scanning to antenatal visits at the health center would encourage or discourage potential patients was unknown. Our study sought to evaluate trends in the numbers of antenatal visits and deliveries at the clinic, pre- and post-introduction of antenatal ultrasound to determine what effect the presence of ultrasound at the clinic had on these metrics.

Methods and Findings: Records at Nawanyago clinic were reviewed to obtain the number of antenatal visits and deliveries for the 42 months preceding the introduction of ultrasound and the 23 months following. The monthly mean deliveries and antenatal visits by category (first visit through fourth return visit) were compared pre- and post- ultrasound using a Kruskal-Wallis one-way ANOVA. Following the introduction of ultrasound, significant increases were seen in the number of mean monthly deliveries and antenatal visits. The mean number of monthly deliveries at the clinic increased by 17.0 (13.3–20.6, 95% CI) from a pre-ultrasound average of 28.4 to a post-ultrasound monthly average of 45.4. The number of deliveries at a comparison clinic remained flat over this same time period. The monthly mean number of antenatal visits increased by 97.4 (83.3–111.5, 95% CI) from a baseline monthly average of 133.5 to a post-ultrasound monthly mean of 231.0, with increases seen in all categories of antenatal visits.

Ross, et al., evaluate the impact of introducing ultrasound at a community health center in rural Uganda as a means of screening for high risk pregnancies. The researchers found that both the number of prenatal visits to the health center as well as the number of deliveries at the health center increased after introduction of the ultrasound, indicating that the ultrasound helped encourage women to come to the health center for prenatal care and delivery. As the authors mention, “Anecdotal impressions from women’s comments at the clinic suggest that the presence of ultrasound technology increased trust in the health care system.”