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Understanding rural women's preferences for telephone call engagement with primary health care providers in Nigeria: a discrete choice experiment
  1. Nasir Umar1,
  2. Zelee Hill2,
  3. Joanna Schellenberg1,
  4. Nuraddeen Umar Sambo3,
  5. Abdulrahman Shuaibu4,
  6. Abdulkarim M Aliyu5,
  7. Kallah Kirpu Kulani5,
  8. Muhammad U Abdullahi5,
  9. Ahmed Usman5,
  10. Hafsat Mohammed5,
  11. Hajara Adamu5,
  12. Maryam Ibrahim5,
  13. Adamu Mohammed5,
  14. Adama Abdulhamid5,
  15. Zainab Muhammed5,
  16. Afodiya Alfayo5,
  17. Tanya Marchant1
  1. 1Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK
  2. 2Institute for Global Health, University College London, London, UK
  3. 3DRMC, Abuja, Nigeria
  4. 4Office of the Executive Secretary, State Primary Health Care Development Agency, Gombe, Nigeria
  5. 5Gombe State Primary Health Care Development Agency, Gombe, Nigeria
  1. Correspondence to Dr Nasir Umar; Nasir.Umar{at}lshtm.ac.uk

Abstract

Background The COVID-19 pandemic has accelerated the use of mobile phones to provide primary health care services and maintain continuity of care. This study aims to understand rural women’s preferences for telephone call engagement with primary health care providers in Nigeria.

Methods A discrete choice experiment was conducted alongside an action research project that empowered primary health care workers to develop and implement a telephone call intervention to assess and enhance experiences with facility childbirth care. Between January and March 2022, 30 providers from 10 primary health care facilities implemented the choice experiment among rural women who had institutional childbirth to elicit service user preferences for telephone call engagement. The women were asked to express their preferred scenario for telephone call engagement with their primary health care providers. Generalised linear mixed models were used to estimate women’s preferences.

Results Data for 460 women were available for the discrete choice experiment. The study showed that rural women have preferences for telephone call engagement with primary health care providers. Specifically, women preferred engaging with female to male callers (β=1.665 (95% CI 1.41, 1.93), SE=0.13, p<0.001), preferred call duration under 15 min (β=1.287 (95% CI 0.61, 1.96), SE=0.34, p<0.001) and preferred being notified before the telephone engagement (warm calling) (β=1.828 (95% CI 1.10, 2.56), SE=0.37, p<0.001). Phone credit incentive was also a statistically significant predictor of women’s preferences for engagement. However, neither the availability of scheduling options, the period of the day or the day of the week predicts women’s preferences.

Conclusions The study highlights the importance of understanding rural women’s preferences for telephone call engagement with healthcare providers in low-income and middle-income countries. These findings can inform the development of mobile phone-based interventions and improve acceptability and broader adoption.

  • health economics
  • health systems
  • maternal health
  • public health

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Handling editor Lei Si

  • Collaborators Listening to Mothers Study group: Kallah Kirpu Kulani (Gadam PHC), Muhammad U Abdullahi (Dirri PHC), Ahmed Usman (Abuja PHC), Hafsat Mohammed (Kwami PHC), Hajara Adamu (Dukul PHC), Maryam Ibrahim (Malleri PHC), Adamu Mohammed (Daban Fulani PHC), Adama Abdulhamid (Doho PHC), Zainab Muhammed (Doho PHC) and Afodiya Alfayo (Malam Sidi PHC).

  • Contributors NU, TM, JS and ZH conceptualised the study. NU, TM, JS, ZH and the Listening to Mothers Study group co-designed the study. NU, TM, JS, ZH, NUS, AS and the Listening to Mothers Study group revised the manuscript and provided critically important intellectual content. All authors read and approved the final manuscript. The Listening to the Gombe Mothers Study group collected data. NU is responsible for the overall content as the guarantor.

  • Funding This work was supported by IDEAS—Informed Decisions for Actions to improve maternal and newborn health (http://ideas.lshtm.ac.uk), funded through a grant from the Bill & Melinda Gates Foundation to the London School of Hygiene & Tropical Medicine (Gates Global Health grant number: OPP1149259).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.