Use of mobile phone: Communication barriers in maternal and neonatal emergencies in rural Bangladesh

  Toll free mobile phone intervention was tested in one sub district of Bangladesh. Prior to implementation, we conducted a formative research to explore perceived advantages and disadvantages of mobile phone communication for maternal and neonatal complication management. We conducted in-depth interviews among twelve community skilled birth attendants and fourteen mothers along with their husbands. All husbands were supportive in their wives’ accessibility to their phone, but wives revealed disparity in access to husbands’ phone. The advantages identified were reduced cost of consultation and transportation to appointments with skilled providers, time saving during emergencies and controlling barriers to pregnant women’s mobility. Other direct benefit was consultation with  health professionals to increase confidence of community based skilled birth attendants (CSBAs) in handling emergencies. Respondents sensed that determining the management without examining patient might affect the appropriateness in providing treatment, when the communication mode is only phone. Mothers and their husbands who communicated through mobile phone with providers for their health issue noted some other barriers: irritability from the provider’s side and switched off phones. Mobile phone access pathway should be explained to pregnant women, their husbands and service providers from the beginning of an intervention. The well designed e-health solutions based on evidence of formative research may have larger impact on quality of care in Bangladesh.   Key words: Maternal and neonatal emergencies, mobile phone, barriers, rural Bangladesh.