Why do women not deliver in health facilities: a qualitative study of the community perspectives in south central Ethiopia?

BMC Research Notes

Mesganaw Fantahun Afework²  Seifu Hagos Gebreyesus²  Alemayehu Mekonen Lemma²  Emebet Mahmoud Hassen¹  Meselech Assegid Roro² 

[1] Center for Population Studies, Addis Ababa University, Addis Ababa, Ethiopia;Department of Reproductive health and health service management, School of Public Health, College of Health Sciences, Addis Ababa University, P.O.Box 28287/1000, Addis Ababa, Ethiopia

关键词: Ethiopia;    Community perspective;    Skilled attendant at birth;    Delivery;    Qualitative;   

Others  :  1130264
DOI  :  10.1186/1756-0500-7-556

 received in 2014-01-03, accepted in 2014-08-14,  发布年份 2014

【 摘 要 】

Background

In Ethiopia most childbirth occurs at home and is not assisted by skilled birth attendants. On the other hand having a birth attendant with midwifery skills during child birth is one of the most important interventions in reducing maternal morbidity and mortality. The objective of this study was to make an in-depth assessment of reasons why mothers do not use health facilities for child delivery.

Methods

Focus Group Discussions were used to gather information on use of health facilities for delivery in Butajira districts of South Central Ethiopia. The study was conducted from January to February 2012. Information was collected from four groups of women who had delivered in the past two years and four groups of men whose wives/partners have delivered in the same period. Data was coded and categorized using open code, qualitative data management software and analyzed based on thematic analysis.

Results

A total of eight FGD sessions, four with women and four with men groups were conducted involving 81 residents of the Butajira district. FGD participants answered that a large majority of women in the district gave birth at home. Two major themes, client related factors and facility/staff factors, emerged. Factors that emerged within major themes of client factors were decision making on place of delivery, reliance on Traditional Birth Attendants (TBAs), misconception about services provided at health facility, inability of family members to be present at time of labor and delivery, lack of privacy, traditional and/or spiritual factors, economic factors and accessibility to health care facilities. Within major themes of facility/staff factors subthemes that emerged were poor reception, refusal of admission, lack of privacy, information gap, poor competence and shortage of staff and materials at health facilities.

Conclusion

Women in the study areas do not deliver in health facilities because of reasons that can be attributed to health care system and client related factors. These need to be addressed by considering the specific factors related to the health system and community perspectives.

【 授权许可】

   
2014 Roro et al.; licensee BioMed Central Ltd.

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