Evaluating the effectiveness of the global position system beaded bracelets to improve the uptake of antenatal care, health facility delivery, and post-natal care services among pastoralist women in Kenya.

BACKGROUND

Antenatal Care (ANC), Health Facility Delivery (HFD), and Postnatal Care (PNC) are the leading indicators of improving maternal and child healthcare globally. This study investigated the effectiveness of a prototyped Global Position System (GPS) beaded bracelet intervention in enhancing maternal healthcare services uptake among pastoralist communities.

METHODS

In this Randomized Control Trial (RCT), one hundred and seven pregnant women in their first trimester were randomly allocated to the intervention group (n = 52) and control group (n = 55). A GPS-beaded bracelet was given to the intervention group for the study duration of 16 months (6 months before delivery and 10 months after delivery). Meanwhile, the non-intervention group received routine ante- and postnatal care. The Pearson X2 test and multivariate logistic regression analysis were conducted using IBM SPSS version 27.0, following the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Model fit was assessed using, the Omnibus test of model Co-efficient, classification table, Nagelkerke R Square, and the Hosmer-Lemeshow test. The significance level was set at p < 0.05. RCT was registered (ISRCTN15438206), and the GPS beaded bracelet was patented by Kenya Industrial Property Institutes (KIPI) NO: KE/UM/19/1211.

RESULTS

Women in the intervention group have nine-fold higher likelihood of having more than four ANC visits (AOR 9.13, 95 % CI 1.75-47.54), three-fold higher likelihood of having postnatal care (AOR 2.71, 95 % CI 0.74-9.96), and a fourfold higher of giving live birth (AOR 3.56, 95 % CI 0.47-27.07) compared to women in the control group. No significant differences were noted between groups when it comes to place of delivery, indicating that while GPS may facilitate access to health facilities, it did not markedly change delivery outcomes based on location, but there is likelihood of delivering in a health facility (OR 2.0, 95 % CI 0.39-8.21). Other variables like age group, literacy level, and distance from health facility didn't exhibit a statistically significant association. All three methods of model fit assessment indicated good model fit.

CONCLUSION

The study result showed the effectiveness of GPS-beaded bracelets by significantly improving ANC, HFD, and PNC attendance and reducing infant mortality. Future studies should focus on refining these technologies to explore the long-term impacts and scalability of such interventions across diverse pastoralist populations to improve maternal and child healthcare.