Cambridge & Makerere Universities, Uganda

Cambridge & Makerere Universities, Uganda

With researchers at the Universities of Cambridge and Makerere, Africa’s Voices sought to understand socio-cultural beliefs about complications during pregnancy in Kampala, Uganda.

In 2015, our interactive radio pilot gathered the views of over 2000 Ugandans (49.6% female) over four weeks on maternal health issues. Our analysis of the SMS data revealed a range of insights into what beliefs influence pregnant women’s decision to seek maternal health services.

For example, we identified gender variations in perception of internal causes (related to biology or supposedly dispositional traits of the mother) vs external causes (linked to low quality of health care, lack of support from husband of complications during pregnancy). Men tend to perceive internal causes, women more. In turn, men tend to perceive themselves and their partners as not at risk, and that complications are more likely to happen to women other than their partner.

Our pilot taught us many lessons about the best ways to reach and engage Ugandans, especially women, through interactive radio and SMS. Insights demonstrate the potential of Africa’s Voices method to provide rich, impactful insights into socio-cultural beliefs related to medical conditions and practices.

Explore our Uganda project through the presentation below, which can be enlarged to full screen, or check out this poster that summarises the pilot.

Project team: Dr. Claudia Abreu Lopes (research lead), Rainbow Wilcox (project manager), Grace Kentaro (research assistant), Giles Barton-Owen (data analyst), Dr. Sharath Srinivasan (director) and Meddie Baliddawa (translator).

Research collaborators: Prof. Ashley Moffett, Dr. Annettee Nakimuli, Prof. Grace Kyomuhendo, and Dr. Gabriel Recchia.

During the month-long series of radio programmes we received over 4000 text messages! The first phase of analysis looked at the quantitative data collected: numbers of participants, their location, age and gender. Below is the results from this initial analysis for radio station CBS FM. A similar infographic was provided for each station that took part to thank them for their involvement and so they can share results with their audiences.

 

CBS: Titi & Mpinga
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Every radio show began with a testimonial from a woman who had experienced pre-eclampsia – each with different, sometimes tragic, outcomes.

Listen to the testimonial (in Luganda) of Nangoma*, which was played in the first show, when the audience was asked “What do you think caused Nangoma’s problems?”. Below is an English translation. NB: high blood pressure is a key symptom of pre-eclampsia.

“During my first pregnancy I went for my first antenatal appointment at eight months. That is when I got to know I had mild blood pressure and was given an injection and stayed there for monitoring. But the pressure was increasing. I was admitted to the hospital on that day, slept there and the pressure kept increasing.For a long time I hadn’t gone to antenatal because I was scared of the hospital telling me those things of pressure. I was not feeling any pain that is why I did not bother to go for antenatal until 8 months. 

I woke up in the morning and pressure was just increasing because of the medicine I had been injected with. Even the baby was affected. The baby’s heartbeat was so low that I was rushed to the theatre for emergency cesarean. Unfortunately the operation was delayed and my baby died because the baby was too tired. The baby was due in two weeks, but was removed at eight months because of my high blood pressure.

I have been pregnant four times with high blood pressure but only my third baby survived and is now five years and a half. The pregnancy of my third baby I got to know that I had pressure through my mouth when I was having lunch. I got paralysed in the mouth – it felt like electricity in the mouth. Then I went to the hospital they told me I was suffering from high blood pressure again. The third pregnancy survived because doctors made a decision to remove the baby at seven months.

I studied and heard that only fat people are the only ones who suffer from high blood pressure. I didn’t know that pregnancy brings pressure but learnt from the hospital. I found other women with the same conditions in the hospital. They used to tell us that swollen feet is a sign of twins in the womb, but I got to know from the hospital that it is a sign of high blood pressure. I also had headache because of pressure but when I went for check-up for pressure it is there but mild. 

I don’t have any problem of high blood pressure when am not pregnant and I don’t even take any medicine. My husband thinks that when pregnant am too tough and very angry all the time and that is why I develop high blood pressure. Other people think that stressing myself with problems and work lead to this condition, I do a lot of hard work that is why my pregnancies do not survive and I get high blood pressure on each pregnancy.”

*All names changed here and during radio shows to protect the privacy of the contributors

Working with local, well-established radio partners (CBS, Beat FM and Akaboozi FM and Straight Talk Foundation) we ran a series of discussion shows in Luganda (the major language of Uganda) about issues related to complications in pregnancy in August 2015. Audience members text in, with messages managed by an SMS platform developed by Text to Change.

Meet the radio hosts in the photos below: