1
|
Aman M, Bekele A, Abamecha F, Lemu YK, Gizaw AT. Husband's intention to support during pregnancy for the use of maternity waiting home in Jimma Zone, Southwest, Ethiopia: a community-based cross-sectional study. Front Glob Womens Health 2024; 5:1342687. [PMID: 38952839 PMCID: PMC11215070 DOI: 10.3389/fgwh.2024.1342687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/29/2024] [Indexed: 07/03/2024] Open
Abstract
Background Husbands are the primary decision-makers about the place of childbirth. Lack of husbands' support for maternal health care is associated with low maternal waiting home utilization and less is known about the husbands' intention to support their wife's use of maternal waiting homes (MWHs) and underlying beliefs in Ethiopia. This community-based cross-sectional survey aimed to study husbands' intention to support during pregnancy through the use of maternity waiting homes in Jimma Zone, Southwest Ethiopia. Method A cross-sectional study was conducted among 396 randomly selected husbands whose wives were pregnant. Interviewer-administered, a structured questionnaire developed based on the Theory of Planned Behavior (TPB) was used to collect the data. Multivariable logistic regression analyses were used to examine the association between behavioral intention and constructs of the theory of planned behavior. Results Of the 396 husbands who took part in the study, 42.7% intend to support their partner's use of a maternity waiting home. Intention to support a wife to use a maternity waiting home was associated with subjective norm [AOR = 1.303, 95% CI (1.054, 1.611)] and perceived behavioral control [AOR = 1.446, 95% CI (1.234, 1.695)]. Among the control beliefs, "having childcare"; "having a person who stays with a wife at a maternity waiting home"; and "availability of quality service provided to a wife in the maternity waiting home" significantly separated intenders and non-intenders. Conclusion The findings suggest that husbands who perceived more social pressure and felt in control of barriers were more likely to intend to support their partner in using a maternity waiting home. Intervention should focus on underlying normative and control beliefs to improve the husband's intention.
Collapse
Affiliation(s)
- Mamusha Aman
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Adisu Bekele
- Mana District Health Department, Oromia, Ethiopia
| | - Fira Abamecha
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Yohannes Kebede Lemu
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abraham Tamirat Gizaw
- Department of Health, Behavior, and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| |
Collapse
|
2
|
Tamiso A, Jisso M, Abera N, Alemayehu A, Gadisa A, Umer A, Kebede M, Mohammed H, Yazie B, Gizaw HS, Mizana BA, Yesuf EA, Tilahun B, Endehabtu BF, Gonete TZ, Gashu KD, Angaw DA, Gurmu KK, Fikre R. Barriers Towards Obstetric Care Service Utilization in Ethiopia: An Explorative Qualitative Study. Ethiop J Health Sci 2023; 33:105-116. [PMID: 38352664 PMCID: PMC10859740 DOI: 10.4314/ejhs.v33i2.4s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/09/2023] [Indexed: 02/16/2024] Open
Abstract
Background Obstetric care has been at the center of both global and national agendas. More than 50% of pregnant mothers are still preferring to give birth at home with some even after having full antenatal care. However, a few literatures looked at contributing factors for this problem but they are not conclusive and do not consider different sociocultural context of Ethiopia and different health service related barriers. Hence, the aim of this study was to explore barriers to obstetric care service utilization in Ethiopia using the socio-ecological model. Methods Explorative qualitative study was employed involving key-informant interviews, in-depth interviews, and focus group discussions between October and December 2021; Individual, community, health system, and contextual barriers were explored. Atlas ti. Version 9 was used for analysis. Result Lack of awareness, unfavorable perception, lack of partner involvement, cultural barrier, shortage of supplies, poor infrastructure, provider-related factors, poor monitoring, and evaluation system, challenging topography, and conflict were the major barriers that hinder mothers from receiving obstetrics service in Ethiopia. Conclusion Lack of awareness, unfavorable perception, conflict, problems with health system structure and process, and cultural and geographical conditions were major barriers in Ethiopia. Therefore, packages of intervention is important to avail essential equipment, strengthening follow up system, create awareness, and increase access to health facilities is very important for service improvement by the government and non-governmental organizations. Additionally, implementing conflict resolution mechanism is important for addressing better obstetric service.
Collapse
Affiliation(s)
- Alemu Tamiso
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| | - Meskerem Jisso
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| | - Netsanet Abera
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| | | | - Anteneh Gadisa
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| | - Abdurezak Umer
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Mesfin Kebede
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Hussen Mohammed
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | - Bekele Yazie
- Dire Dawa University, College of Medicine and Health Sciences, Ethiopia
| | | | | | | | - Binyam Tilahun
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
| | | | - Tajebew Zayede Gonete
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
| | - Kassahun Dessie Gashu
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
| | - Dessie Abebew Angaw
- University of Gonder, College of Medicine and Health Science, Institute of Public Health, Ethiopia
| | - Kassu Ketema Gurmu
- World Health Organization Country Office for Ethiopia, Universal Health Coverage/Life Course, Health System Strengthening Team, Addis Ababa, Ethiopi
| | - Rekiku Fikre
- Hawassa University, College of Medicine and Health Sciences, Ethiopia
| |
Collapse
|
3
|
Toja E, Abebe A, Mekonen N, Baza D. Why Home Delivery After Full Antenatal Care Follow-Up in Southern Ethiopia? An Exploratory-Descriptive Qualitative Study. Int J Womens Health 2022; 14:765-775. [PMID: 35719720 PMCID: PMC9200408 DOI: 10.2147/ijwh.s365244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022] Open
Abstract
Background Pregnant women who had full antenatal care follow-up are expected to give birth in health facilities. However, in Ethiopia, after full antenatal care booking, many women still prefer to give birth at home. Thus, the purpose of this study was to explore and describe why women give childbirth at home after full antenatal care follow-up in the study setting. Methods Exploratory-descriptive qualitative design was conducted in Humbo and Abala Abaya districts, Southern Ethiopia, from June to September 2020. Nine in-depth interviews and four focus group discussions were held with purposively selected participants. Women who gave birth at home after attending equal to or more than four antenatal care appointments in the last year were included. The collected data were majorly analyzed by inductive thematic analysis technique, but deductive analysis was also applied whenever the potential themes needed further enrichment. A thick description of the findings is done in the respective heading and sub-heading using participants’ verbatim quotations. Results A total of 9 in-depth interviews and four focus group discussions comprising 35 participants was conducted. Three major themes and nine sub-themes emerged from the data. Socio-cultural and community influences, socio-economic obstacles, and health system-related barriers are the major themes identified. Traditional practices, personal beliefs, social norms, knowledge, and attitude about institutional delivery, household economic capability, decision-making capacity of the women, delivery service quality, and service providers related barriers are the sub-themes defining the home delivery experience of women after full antenatal care follow-up in the study setting. Conclusion In this study, socio-economic, cultural, and health system-related barriers are major reasons for home delivery. Improvement of public awareness on the risk of home delivery and elimination of its facilitative social norms, empowerment of women’s economic, educational, and decision-making capability and healthcare workers’ and health facilities’ capacity are recommended.
Collapse
Affiliation(s)
- Eshetu Toja
- Department of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amene Abebe
- Department of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Niguse Mekonen
- Department of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Daniel Baza
- Department of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| |
Collapse
|
4
|
Ngotie TK, Kaura DKM, Mash B. Awareness of cultural practices by skilled birth attendants during pregnancy and birth in Kenya: An interpretive phenomenological study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
5
|
Mehretie Adinew Y, Kelly J, Marshall A, Smith M. Care Providers' Perspectives on Disrespect and Abuse of Women During Facility-Based Childbirth in Ethiopia: A Qualitative Study. Int J Womens Health 2021; 13:1181-1195. [PMID: 34876861 PMCID: PMC8643202 DOI: 10.2147/ijwh.s333863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/25/2021] [Indexed: 11/24/2022] Open
Abstract
Background It is increasingly evident that disrespect and abuse of women during facility-based childbirth is a violation of a woman’s rights and a deterrent to the use of life-saving maternity care. Understanding care providers’ perspectives of disrespect and abuse during facility-based childbirth is an essential element to aid in fully comprehending the problem and its underlying complexities. Objective To explore care providers’ perspectives of disrespect and abuse during facility-based childbirth. Methods This study used a qualitative descriptive design involving fifteen in-depth, semi-structured, interviews conducted between 5 October 2019 and 25 January 2020 in north Showa zone of Oromia region, central Ethiopia. Purposive sampling enabled health care professionals working in maternity units of health facilities who have direct involvement in care of women during pregnancy and labor to be recruited. Thematic analysis using Open Code software was used to explore the perspectives of participants. Results Four themes were identified. 1) Disrespect and abuse breaches professional standards, 2) Disrespectful and abusive actions are justified at times to save the mother and her baby, 3) Disrespect and abuse is used as a tool to assert power, and 4) Disrespect and abuse arise from health system deficiencies. Conclusion Disrespect and abuse is triggered by underlying beliefs about risk versus care, provider attitudes, stress and burnout, and health service structural issues including a lack of medicines and supplies. A number of strategies could improve the quality of maternity care, including training providers how to manage difficult and complex situations, addressing root causes of disrespect and abuse, and increasing access to resources.
Collapse
Affiliation(s)
- Yohannes Mehretie Adinew
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia.,College of Health Sciences and Medicine, Wolaita Sodo University, Sodo, Ethiopia
| | - Janet Kelly
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia
| | - Amy Marshall
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Morgan Smith
- Adelaide Nursing School, The University of Adelaide, Adelaide, Australia
| |
Collapse
|
6
|
Mordal E, Hanssen I, Kassa A, Vatne S. Mothers' Experiences and Perceptions of Facility-based Delivery Care in Rural Ethiopia. Health Serv Insights 2021; 14:11786329211017684. [PMID: 34045866 PMCID: PMC8135210 DOI: 10.1177/11786329211017684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/23/2021] [Indexed: 11/18/2022] Open
Abstract
In Ethiopia, delivery wards are a part of primary healthcare services. However, although the maternal mortality rate is very high, approximately 50% of mothers use skilled birth attendants. This study focused on how women in a rural southern district of Ethiopia experience maternity care offered at the local delivery wards. In this qualitative, exploratory study, 19 women who had given birth in a healthcare facility were interviewed in 2019. Individual in-depth interviews were supplemented with observations conducted at 2 different delivery wards in the same district in 2020. Two main themes emerged from the thematic content analysis: increased awareness and safety were the primary reasons for giving birth at a healthcare facility, and traditions and norms affected women’s birth experiences in public maternity wards. The main shortcomings were a shortage of medicine, ambulance not arriving in time, and lack of care at night. For some women, being assisted by a male midwife could be challenging, and the inability to afford necessary medicine made adequate treatment inaccessible. Providing continuous information gave the women a certain feeling of control. Strong family involvement indicated that collectivistic expectations were key to rural delivery wards. The healthcare system must be structured to meet women’s needs. Moreover, managers and midwives should ensure that birthing women receive high-quality, safe, timely, and respectful care.
Collapse
Affiliation(s)
- Elin Mordal
- Molde University College, Specialized University in Logistics, Molde, Norway
| | | | | | - Solfrid Vatne
- Molde University College, Specialized University in Logistics, Molde, Norway
| |
Collapse
|
7
|
Disrespect and Abuse during Childbirth in Ethiopia: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8186070. [PMID: 33150181 PMCID: PMC7603554 DOI: 10.1155/2020/8186070] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/20/2020] [Accepted: 10/03/2020] [Indexed: 11/22/2022]
Abstract
Background Disrespect and abuse are recognized for the restricting impact of women from seeking maternal care, psychological humiliations, grievances, and unspoken sufferings on women during childbirth. Individual primary studies are limited in explaining of extent of disrespect and abusive care. Hence, this review considers the synthesis of comprehensive evidence on the extent, contributing factors, and consequences of disrespectful and abusive intrapartum care from the women's and providers' perspectives in Ethiopia. Methods Articles had been systematically searched from the databases of PubMed, Cochrane Library, POPLINE, Google Scholar, HINARI, African Journals Online, and WHO Global Health Library. A qualitative and quantitative synthesis was performed using the Bowser and Hill landscape analytical framework. Result Twenty-two studies comprised of the 16 quantitative; 5 qualitative and one mixed studies were included. The most repeatedly dishonored right during facility-based childbirth in Ethiopia was nondignified care, and the least commonly reported abuse was detention in health facilities. These behaviors were contributed by normalization of care, lack of empowerment and education of women, weak health system, and lack of training of providers. Women subjected to disrespectful and abusive behavior distanced themselves from the use of facility-based childbirth-related services and have endured psychological humiliations. Conclusion Disrespectful and abusive care of women during childbirth is repeatedly practiced care in Ethiopia. This result specifically described the contributing factors and their effects as a barrier to the utilization of facility-based childbirth. Therefore, to overcome this alarming problem, health systems and care providers must be responsive to the specific needs of women during childbirth, and implementing policies for standard care of respectful maternity care must be compulsory. In addition, observational, qualitative, and mixed types of studies are required to provide comprehensive evidences on disrespect and abusive behavior during childbirth in Ethiopia.
Collapse
|
8
|
Malatji R, Madiba S. Disrespect and Abuse Experienced by Women during Childbirth in Midwife-Led Obstetric Units in Tshwane District, South Africa: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3667. [PMID: 32456063 PMCID: PMC7277802 DOI: 10.3390/ijerph17103667] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/28/2020] [Accepted: 05/06/2020] [Indexed: 11/16/2022]
Abstract
The disrespect and abuse (D&A) of women during childbirth is common and a great concern in midwifery-led obstetric units (MOUs) in South Africa. This paper used the seven chapters of the Respectful Maternity Care Charter as a framework to explore women's experiences of care during childbirth and examine the occurrence of D&A during childbirth in MOUs. Five focus group interviews were conducted with postnatal women aged 18 to 45 years selected purposively from MOUs in Tshwane District in South Africa. The discussions were audio-recorded, transcribed, and analyzed using a thematic approach and NVivo11 computer software. D&A of women was common during labor and childbirth. Verbal abuse in the form of shouting, labeling, judging, and rude remarks was the common form of D&A. Some of the women were abandoned and neglected, which resulted in their giving birth without assistance. Furthermore, the midwives violated their rights and denied them care such as pain relief medication, birth companions during childbirth, and access to ambulance services. Midwives are at the center of the provision of maternity care in MOUs in South Africa. Therefore, there is a need to strengthen interventions to adopt and implement policies that promotes respectful, nonabusive care during childbirth in MOUs.
Collapse
Affiliation(s)
| | - Sphiwe Madiba
- Department of Public Health, Sefako Makgatho Health Sciences University, P.O. Box 215 Medunsa 0403, Pretoria 0001, South Africa;
| |
Collapse
|
9
|
Devkota B, Maskey J, Pandey AR, Karki D, Godwin P, Gartoulla P, Mehata S, Aryal KK. Determinants of home delivery in Nepal - A disaggregated analysis of marginalised and non-marginalised women from the 2016 Nepal Demographic and Health Survey. PLoS One 2020; 15:e0228440. [PMID: 31999784 PMCID: PMC6992204 DOI: 10.1371/journal.pone.0228440] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 01/16/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION In Nepal, a substantial proportion of women still deliver their child at home. Disparities have been observed in utilisation of institutional delivery and skilled birth attendant services. We performed a disaggregated analysis among marginalised and non-marginalised women to identify if different factors are associated with home delivery among these groups. MATERIALS AND METHODS This study used data from the 2016 Nepal Demographic and Health Survey. It involves the analysis of 3,837 women who had experienced at least one live birth in the five years preceding the survey. Women were categorised as marginalised and non-marginalised based on ethnic group. Bivariate and multivariable logistic regression analysis were performed to identify factors associated with home delivery. RESULTS A higher proportion of marginalised women delivered at home (47%) than non-marginalised women (26%). Compared to non-marginalised women (35%), a larger proportion of marginalised women (64%) felt that it was not necessary to give birth at health facility. The multivariable analysis indicated an independent association of having no or basic education, belonging to middle, poorer and the poorest wealth quintile, residing in Province 2 and not having completed of four antenatal care visits per protocol with home delivery among both marginalised and non-marginalised women. Whereas residing in a rural area, residing in Province 7, and at a distance of >30 minutes to a health facility were factors independently associated with home delivery only among marginalised women. CONCLUSION We conclude that poor education, poor economic status, non-completion of four ANC visits and belonging to Province 2 particularly determined either group of women to deliver at home, whereas residing in rural areas, living far from health facility, and belonging to Province 7 determined marginalised women to deliver at home. Preventing mothers from delivering at home would thus require focusing on specific geographical areas besides considering wider socio-economic determinants.
Collapse
Affiliation(s)
- Bikash Devkota
- Policy Planning and Monitoring Division, Ministry of Health and Population, Kathmandu, Nepal
| | - Jasmine Maskey
- DFID Nepal Health Sector Programme 3/Monitoring Evaluation and Operational Research, Abt Associates, Kathmandu, Nepal
- * E-mail: ,
| | - Achyut Raj Pandey
- DFID Nepal Health Sector Programme 3/Monitoring Evaluation and Operational Research, Abt Associates, Kathmandu, Nepal
| | - Deepak Karki
- UK Department for International Development Nepal, Kathmandu, Nepal
| | - Peter Godwin
- DFID Nepal Health Sector Programme 3/Monitoring Evaluation and Operational Research, Abt Associates, Kathmandu, Nepal
| | - Pragya Gartoulla
- DFID Nepal Health Sector Programme 3/Monitoring Evaluation and Operational Research, Abt Associates, Kathmandu, Nepal
| | - Suresh Mehata
- Policy Planning and Monitoring Division, Ministry of Health and Population, Kathmandu, Nepal
| | - Krishna Kumar Aryal
- DFID Nepal Health Sector Programme 3/Monitoring Evaluation and Operational Research, Abt Associates, Kathmandu, Nepal
| |
Collapse
|
10
|
Bergen N, Hudani A, Asfaw S, Mamo A, Kiros G, Kurji J, Morankar S, Abebe L, Kulkarni MA, Labonté R. Promoting and delivering antenatal care in rural Jimma Zone, Ethiopia: a qualitative analysis of midwives' perceptions. BMC Health Serv Res 2019; 19:719. [PMID: 31639001 PMCID: PMC6805645 DOI: 10.1186/s12913-019-4596-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite improvements in recent years, Ethiopia faces a high burden of maternal morbidity and mortality. Antenatal care (ANC) may reduce maternal morbidity and mortality through the detection of pregnancy-related complications, and increased health facility-based deliveries. Midwives and community-based Health Extension Workers (HEWs) collaborate to promote and deliver ANC to women in these communities, but little research has been conducted on the professional working relationships between these two health providers. This study aims to generate a better understanding of the strength and quality of professional interaction between these two key actors, which is instrumental in improving healthcare performance, and thereby community health outcomes. METHODS We conducted eleven in-depth interviews with midwives from three rural districts within Jimma Zone, Ethiopia (Gomma, Kersa, and Seka Chekorsa) as a part of the larger Safe Motherhood Project. Interviews explored midwives' perceptions of strengths and weaknesses in ANC provision, with a focus as well on their engagement with HEWs. Thematic content analysis using Atlas.ti software was used to analyse the data using an inductive approach. RESULTS Midwives interacted with HEWs throughout three key aspects of ANC promotion and delivery: health promotion, community outreach, and provision of ANC services to women at the health centre and health posts. While HEWs had a larger role in promoting ANC services in the community, midwives functioned in a supervisory capacity and provided more clinical aspects of care. Midwives' ability to work with HEWs was hindered by shortages in human, material and financial resources, as well as infrastructure and training deficits. Nevertheless, midwives felt that closer collaboration with HEWs was worthwhile to enhance service provision. Improved communication channels, more professional training opportunities and better-defined roles and responsibilities were identified as ways to strengthen midwives' working relationships with HEWs. CONCLUSION Enhancing the collaborative interactions between midwives and HEWs is important to increase the reach and impact of ANC services and improve maternal, newborn and child health outcomes more broadly. Steps to recognize and support this working relationship require multipronged approaches to address imminent training, resource and infrastructure deficits, as well as broader health system strengthening.
Collapse
Affiliation(s)
- Nicole Bergen
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Alzahra Hudani
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Shifera Asfaw
- Department of Health, Behavior & Society, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abebe Mamo
- Department of Health, Behavior & Society, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Getachew Kiros
- Department of Health, Behavior & Society, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Jaameeta Kurji
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| | - Sudhakar Morankar
- Department of Health, Behavior & Society, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Lakew Abebe
- Department of Health, Behavior & Society, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Manisha A. Kulkarni
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| | - Ronald Labonté
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| |
Collapse
|
11
|
Preferences for formal and traditional sources of childbirth and postnatal care among women in rural Africa: A systematic review. PLoS One 2019; 14:e0222110. [PMID: 31553722 PMCID: PMC6760778 DOI: 10.1371/journal.pone.0222110] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/21/2019] [Indexed: 11/19/2022] Open
Abstract
Background The underutilization of formal, evidence-based maternal health services continues to contribute to poor maternal outcomes among women living in rural Africa. Women’s choice of the type of maternal care they receive strongly influences their utilization of maternal health services. There is therefore a need to understand rural women’s preferred choices to help set priorities for initiatives attempting to make formal maternal care more responsive to women’s needs. The aim of this review was to explore and identify women’s preferences for different sources of childbirth and postnatal care and the factors that contribute to these preferences. Methods A systematic literature search was conducted using the Ovid Medline, Embase, CINAHL, and Global Health databases. Thirty-seven studies that elicited women’s preferences for childbirth and postnatal care using qualitative methods were included in the review. A narrative synthesis was conducted to collate study findings and to report on patterns identified across findings. Results During the intrapartum period, preferences varied across communities, with some studies reporting preferences for traditional childbirth with traditional care-takers, and others reporting preferences for a formal facility-based childbirth with health professionals. During the postpartum period, the majority of relevant studies reported a preference for traditional postnatal services involving traditional rituals and customs. The factors that influenced the reported preferences were related to the perceived need for formal or traditional care providers, accessibility to maternal care, and cultural and religious norms. Conclusion Review findings identified a variety of preferences for sources of maternal care from intrapartum to postpartum. Future interventions aiming to improve access and utilization of evidence-based maternal healthcare services across rural Africa should first identify major challenges and priority needs of target populations and communities through formative research. Evidence-based services that meet rural women’s specific needs and expectations will increase the utilization of formal care and ultimately improve maternal outcomes across rural Africa.
Collapse
|
12
|
Gebregziabher NK, Zeray AY, Abtew YT, Kinfe TD, Abrha DT. Factors determining choice of place of delivery: analytical cross-sectional study of mothers in Akordet town, Eritrea. BMC Public Health 2019; 19:924. [PMID: 31291919 PMCID: PMC6617705 DOI: 10.1186/s12889-019-7253-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/28/2019] [Indexed: 11/10/2022] Open
Abstract
Background In Eritrea, facility delivery rates show great discrepancy within urban centers. This study was conducted in Akordet, a multi-cultural lowland town of Gash-Barka Region, aiming at assessing the factors influencing facility delivery. Methods A community based analytical cross-sectional study was conducted among a total of 282 mothers who gave birth within the 2 years preceding the data collection time. Data collection was carried out by going house-to-house and interviewing the mothers using a structured closed ended questionnaire. Bivariate and multivariate logistic regressions were used to determine the magnitude of the relationship between place of delivery and the explanatory variables (Religion, Ethnicity, Mother’s educational level, Husband’s Educational level, Place of delivery preceding last pregnancy, Birth order of last child, Any complications during previous delivery, First ANC Visit during last pregnancy, Number of ANC visits during last pregnancy and Any complication during last pregnancy.). For this study, p-value ≤0.05 was considered as statistically significant. Results The rate of facility delivery in this setting was found to be 82.3%. Almost all (96.1%) the mothers had at least one ANC visit during their last pregnancy, with the majority (59.7%) visiting ANC clinics during second trimester for the first time. Mothers whose educational level is junior and above (AOR 8.8, CI: 1.18–65.64), whose husband’s educational level is junior and above (AOR 3.92, CI: 1.03–14.54), who gave birth in health facility before the last pregnancy (AOR 8.16, CI: 3.41–19.48), and those who had complications during last pregnancy (AOR 2.24, CI: 1.04–4.82) were more likely to deliver in a health facility. Mothers whose last child’s birth order was 4th -6th were less likely (AOR 0.24, CI: 0.090.62) to deliver at health facility. Conclusions Early initiation of ANC and regularity in attendance should be emphasized. Health educations given to pregnant mothers should try to persuade the mothers that each pregnancy and ensuing delivery is unique. Empowering the community in general and women in particular by increasing the level of participation in education might payoff in high level of facility delivery.
Collapse
|