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There is a common belief regarding utilization of antenatal care (ANC) in reducing maternal mortality. Maternal mortality refers to deaths caused by pregnancy or childbirth related complications. About 830 women die every day from pregnancy and childbirth-related complications and it is estimated that 303,000 women died worldwide in 2015 during and following pregnancy and childbirth (World Health Organization, 2018). This is more than 34 women per hour. Of these, 99% occurred in developing countries. Regionally, Sub-Saharan Africa and South Asia accounted for 87% of the global maternal deaths (World Health Organization, 2010). By 2016, the maternal mortality rate in Uganda was 336 deaths per 100,000 live births (Uganda Demographic and Health Survey, 2016). An estimated 16 women die from giving birth every day; on average this is one death every hour and a half, and nearly 6,000 every year in Uganda (Ministry of Finance Planning and Economic Development, 2015). The major complications that account for 75 to 80 percent of deaths include: haemorrhage, sepsis, unsafe abortions, pre-eclampsia and obstructed labour (WHO, 2018), while the indirect causes contribute 20 to 25 per cent and these include: HIV/AIDS, malaria, anaemia, malnutrition, hepatitis and diabetes (Nieburg, 2012; United Nations Children’s Fund, 2009). A growing consensus suggests that these conditions are preventable with 80 percent of these deaths capable of being averted if women have access to essential maternity, basic health services, emergency obstetric care (EmOC) and participate in ANC (United Nations Children’s Fund, 2009; Lewis, 2008; Atekyereza & Mubiru, 2014). ANC provides an avenue for mothers to receive information and guidance on safe childbirth and help prevent, detect and alleviate health problems that affect mothers and babies during pregnancy (Nieburg, 2012, Kuhnt & Vollmer, 2017). ANC establishes the first contact with health facilities, and it is highly premised that mothers who have attended at least more than one ANC are more likely to give birth with the help of a skilled birth attendant (Guliani et al., 2012).
Studies have shown the impact of technology in enhancing decisions to utilize ANC (Namatovu, 2018).
Over the years, ICTs have demonstrated good capacity to influence women’s demand of health information (Abekar-Nkrumah, Guerriero & Purohit, 2014). Digital technologies in health involve the use of mobile wireless and fixed technologies such as mobile phones, computers, personal digital assistants, to transmit messages in form of text, audio, video, images etc (WHO 2019, Abekar et al., 2014). mHealth interventions have proved to be effective to improve antenatal care services especially those aimed at changing behavior of pregnant women (Feroz, Perveen & Aftab, 2017). Having a mobile phone and a computer in a household was positively associated with ANC utilization (Abekar et al., 2014). ICTs have been effectively used by patients and medical professionals for distance learning, e-consultation, communication, disease control and prevention through disease surveillance, arranged telemedicine and medical transcriptions (Scott & Mars, 2015; William, et al., 2012). They have a powerful prospect for improving health in remote areas (Parvin, 2015).
The role of ICT uptake in ANC utilization has not been extensively researched (Abekar et al., 2014) yet ICT has been exalted as a key ingredient in improving health service delivery. It is against this background that this study investigated the extent to which ICT uptake, alongside other barriers, determine ANC utilization demonstrated in Figure 1. This conceptual model illustrates ANC determinants which drew from existing studies (Anastasi et al., 2015; Thaddeus & Maine, 1994) that describe the barriers/facilitators of ANC utilization. This conceptual model integrated ICT uptake as a moderating variable which was not included in the above stated models.