TY - JOUR T1 - Strengthening Kampala’s Urban Referral System for Maternal and Newborn Care Through Establishment of an Emergency Call and Dispatch Center JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT DO - 10.9745/GHSP-D-22-00332 AU - Sam Ononge AU - Andrew Magunda AU - Dorothy Balaba AU - Peter Waiswa AU - Daniel Okello AU - Henry Kaula AU - Sara Zalwango AU - Douglas Akii Bua AU - Amable Ayebare AU - Frank Kaharuza AU - Cudjoe Bennett AU - Sara Sulzbach AU - Brett Keller AU - Yvonne Mugerwa Y1 - 2023/05/18 UR - http://www.ghspjournal.org/content/early/2023/05/17/GHSP-D-22-00332.abstract N2 - Key FindingsThe Kampala Slum Maternal and Newborn Health project established an emergency call and ambulance dispatch center that improved coordination, efficiency, and accountability in the referral and transport of maternal and newborn health emergency cases to higher-level facilities.The project also developed and tested a smartphone application for initiating referral, tracking, and deployment of ambulances. The mobile application was considered an effective and feasible solution for deploying and tracking ambulances and improved driver accountability as locations could be viewed in real time.The mobile application ensured receiving referral facilities were notified, which improved their preparation and management of referral cases.Key ImplicationInvolvement of the district authority and leadership in the planning, designing, and implementation of the intervention may improve ownership, acceptability, and sustainability of the project.Introduction:Most pregnant women living in urban slum communities in Uganda deliver at public health centers that are not equipped to provide emergency obstetric and newborn care. When obstetric emergencies occur, pregnant women are referred to a higher-level facility and are responsible for arranging and paying for their own transport. The Kampala Slum Maternal Newborn (MaNe) project developed and tested an emergency call and ambulance dispatch center and a mobile application to request, deploy, and track ambulances. We describe the development of these 2 interventions and findings on the feasibility, acceptability, and sustainability of the interventions.Methods:MaNe conducted a mixed-method feasibility study that included an assessment of the acceptability and demand of the interventions. In-depth interviews (N=26) were conducted with facility proprietors, health providers, ambulance drivers, Kampala Capital City Authority officers, and community members to understand the successes and challenges of establishing the call center and developing the mobile application. Thematic content analysis was done. Quantitative data from the call center dispatch logs were analyzed descriptively to complement the qualitative findings.Findings:Between April 2020 and June 2021, 10,183 calls were made to the emergency call and dispatch center. Of these, 25% were related to maternal and newborn health emergencies and 14% were COVID-19 related. An ambulance was dispatched to transfer or evacuate a patient in 35% of the calls. Participants acknowledged that the call center and mobile application allowed for efficient communication, coordination, and information flow between health facilities. Supportive district leadership facilitated the establishment of the call center and has taken over the operating costs of the center.Conclusion:The call center and referral application improved the coordination of drivers and ambulances and allowed facilities to prepare for and treat cases more efficiently. ER -