Mobilizing the community to utilize obstetric services, Cross River State, Nigeria

Preliminary studies: Twenty-one focus groups and a survey in two rural communities revealed socioeconomic and cultural barriers to utilization of emergency obstetric services. Interventions: To facilitate the use of services, 20 community educators were trained and an education campaign was conducted beginning in 1994. Educational activities emphasized the need for women with obstetric complications to use obstetric services at two local health facilities and one teaching hospital. Communities were also mobilized to set up loan and transport programs. Results: Awareness of obstetric complications increased in both communities and for all complications: increases ranged from 5% (for obstructed labor) to 63% (for hemorrhage). Fourteen of 39 project communities established new loan programs (six communities already had them). Loans were granted in only nine communities. Transport systems were established in nine communities. Referrals to the teaching hospital of women with major obstetric complications from two health facilities in the study area increased from three in 1990 to 11 in 1995 in one community and from four to eight in the other. Costs: The cost of the mobilization activities was approximately US $6500. Conclusion: Community education and mobilization can help increase awareness of obstetric complications. (C) 1997 International Federation of Gynecology and Obstetrics.