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 utilizati on of emergency obstetric services. Interventions: To facilitate the u se of services, 20 community educators were trained and an education c ampaign was conducted beginning in 1994. Educational activities emphas ized the need for women with obstetric complications to use obstetric services at two local health facilities and one teaching hospital. Com munities were also mobilized to set up loan and transport programs. Re sults: Awareness of obstetric complications increased in both communit ies and for all complications: increases ranged from 5% (for obstructe d labor) to 63% (for hemorrhage). Fourteen of 39 project communities e stablished new loan programs (six communities already had them). Loans were granted in only nine communities. Transport systems were establi shed in nine communities. Referrals to the teaching hospital of women with major obstetric complications from two health facilities in the s tudy 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 mobilizati on activities was approximately US $6500. Conclusion: Community educat ion and mobilization can help increase awareness of obstetric complica tions. (C) 1997 International Federation of Gynecology and Obstetrics.