scholarly journals Why institutional delivery is still the last option to rural women in North West Ethiopia: Qualitative study

2019 ◽  
Author(s):  
Netsanet Fentahun Babbel ◽  
Wubegzier Mekonnen ◽  
Yosef Wasihun ◽  
Mulunesh Alemayehu
Keyword(s):  
Risk Perception ◽  
Qualitative Study ◽  
Health Facility ◽  
Rural Women ◽  
Institutional Delivery ◽  
Cultural Beliefs ◽  
Home Delivery ◽  
Health Facilities ◽  
Care Providers ◽  
Related Factors

Abstract Background: whatever the actions has been implemented, home delivery preference in Ethiopia is still over 72%. To date, no studies explored why institutional delivery is still the last option to rural women in Ethiopia. This study was conducted to explore the reason why institutional delivery is still the last option to rural women in Awi Zone Northwest Ethiopia.Methods: An explanatory qualitative study was conducted from February to March 2014. Participants were selected purposively and written informed consent was sought. Twelve reproductive aged females, ten religious and twelve community leaders and sixteen key informants were participated. Data were collected by using semi-structured questionnaire using focused group discussion and in-depth interview guides. Thick description and peer debriefing were applied to assure data quality. Thematic analysis framework was used to analyse the data. Results: The study revealed that institutional delivery is still the last option to the study area. Individual related factors like information gap, low risk Perception to pregnancy and delivery have been mentioned as drive factors for not using institutional delivery. Community related factors of women’s poor position to decision, beliefs and cultural practices for home delivery preference affects institutional delivery. In addition, health facility related barriers like inaccessibility of health facility, infrastructure, lack of privacy during delivery, misconducts of health care providers and high risk perception to health facility delivery were repeated raised as reasons of last option of institutional delivery. Conclusion: This study elucidated that home delivery preference was existed, given high social and cultural price for home delivery and misconceptions towards institutional delivery. Thus, the Ethiopian government together with its partners should focus on accessing health facilities, infrastructure, equipping health facilities with essential materials and skilled health professionals and increasing knowledge of the community, avert communities’ misconceptions and deep-rooted socio-cultural beliefs towards institutional delivery.

scholarly journals Why institutional delivery is still the last option to rural women in North West Ethiopia:  Qualitative study

2020 ◽  
Author(s):  
Netsanet Fentahun Babbel ◽  
Yosef Wasihun ◽  
Wubegzier Mekonnen ◽  
Mulunesh Alemayehu Mulunesh Alemayehu
Keyword(s):  
Risk Perception ◽  
Qualitative Study ◽  
Health Facility ◽  
Rural Women ◽  
Institutional Delivery ◽  
Cultural Beliefs ◽  
Home Delivery ◽  
Health Facilities ◽  
Care Providers ◽  
Related Factors

Abstract Background: Whatever the actions has been implemented, home delivery preference in Ethiopia is still over 72%. To date, no studies explored why institutional delivery is still the last option to rural women in Ethiopia. This study was conducted to explore the reason why institutional delivery is still the last option to rural women in Awi Zone Northwest Ethiopia. Methods : An explanatory qualitative study was conducted from February to March 2014. Participants were selected purposively and written informed consent was sought. Twelve reproductive aged females, ten religious and twelve community leaders and sixteen key informants were participated. Data were collected by using semi-structured questionnaire using focused group discussion and in-depth interview guides. Thick description and peer debriefing were applied to assure data quality. Thematic analysis framework was used to analyse the data. Results : The study revealed that institutional delivery is still the last option to the study area. Individual related factors like information gap, low risk Perception to pregnancy and delivery have been mentioned as drive factors for not using institutional delivery. Community related factors of women’s poor position to decision, beliefs and cultural practices for home delivery preference affects institutional delivery. In addition, health facility related barriers like inaccessibility of health facility, infrastructure, lack of privacy during delivery, misconducts of health care providers and high risk perception to health facility delivery were repeated raised as reasons of last option of institutional delivery. Conclusion: This study elucidated that home delivery preference was existed, given high social and cultural price for home delivery and misconceptions towards institutional delivery. Thus, the Ethiopian government together with its partners should focus on accessing health facilities, infrastructure, equipping health facilities with essential materials and skilled health professionals and increasing knowledge of the community, avert communities’ misconceptions and deep-rooted socio-cultural beliefs towards institutional delivery.

scholarly journals Socio-cultural Beliefs and Practices Influencing Institutional Delivery Service Utilization in Three Communities of Ethiopia: A Qualitative Study

1970 ◽  
Vol 29 (3) ◽  
Author(s):  
Sabit Ababor ◽  
Zewdie Birhanu ◽  
Atkure Defar ◽  
Kasahun Amenu ◽  
Amanuel Dibaba ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Facility ◽  
Institutional Delivery ◽  
Health Workers ◽  
Cultural Beliefs ◽  
Cultural Factors ◽  
Beliefs And Practices ◽  
Delivery Service ◽  
Facility Birth ◽  
Health Facility Birth

BACKGROUND: The influence of socio-cultural factors on institutional birth is not sufficiently documented in Ethiopia. Thus, this study explores socio-cultural beliefs and practices during childbirth and its influences on the utilization of institutional delivery services.METHODS: A qualitative study was conducted in three regions of Ethiopia through eight focus group discussions (with women) and thirty in-depth interviews with key informants which included health workers, community volunteers, and leaders. The data were analyzed thematically.RESULTS: The study identified six overarching socio-cultural factors influencing institutional birth in the study communities. The high preference for traditional birth attendants (TBAs) and home as it is intergenerational culture and suitable for privacy are among the factors. Correspondingly, culturally unacceptable birth practices at health facilities (such as birth position, physical assessment, delivery coach) and inconvenience of health facility setting to practice traditional birth rituals such as newborn welcoming ceremony made women avoid health facility birth. On the other hand, misperceptions and worries on medical interventions such as episiotomy, combined with mistreatment from health workers, and lack of parent engagement in delivery process discouraged women from seeking institutional birth. The provision of delivery service by male health workers was cited as a social taboo and against communities' belief system which prohibited women from giving birth at a health facility.CONCLUSIONS: Multiple socio-cultural factors and perceptions were generally affected utilization of institutional birth in study communities. Hence, culturally competent interventions through education, re-orientation, and adaptation of beneficial norms combined with women friendly care are essential to promote health facility birth. 

scholarly journals Exploring COVID-19 Related Factors Influencing Antenatal Care Services Uptake: A Qualitative Study among Women in a Rural Community in Southwest Ethiopia

2021 ◽  
Vol 12 ◽  
pp. 215013272199689
Author(s):  
Shewangizaw Hailemariam ◽  
Wubetu Agegnehu ◽  
Misganaw Derese
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Facility ◽  
Care Service ◽  
Maternal Health Service ◽  
Related Factors ◽  
Factors Influencing

Introduction: Evidences suggest a significant decline in maternal health service uptake following the coronavirus disease 2019 (COVID-19) pandemic in Ethiopia. However, COVID-19 related factors impacting the service uptake are not sufficiently addressed. Hence, the current study was intended to explore COVID-19 related factors influencing antenatal care service uptake in rural Ethiopia. Methods: A community-based qualitative study was conducted from September 25/2020 to November 25/2020 among selected pregnant women residing in rural districts of Bench-Sheko Zone, and healthcare providers working in the local health care facilities. Six focus group discussions and 9 in-depth interviews were made between pregnant women, and health care providers, respectively. Data was collected by health education and behavioral science professionals who also have experience in qualitative data collection procedure. Data were transcribed, translated, and analyzed thematically using Open Code 4.0 software. Result: The study revealed several COVID-19 related factors influencing the uptake of antenatal care service during the pandemic. Health facility related barriers, perceived poor quality of care during the pandemic, government measures against COVID-19, anxiety related to the pandemic, and risk minimization were the identified factors possibly influencing the current antenatal care service uptake among women in rural Bench-Sheko Zone. Conclusion: COVID-19 preventive measures, and health facility related factors and individual factors were responsible for the current decline in antenatal care service uptake. Preserving essential health care service is critical to prevent avoidable losses of maternal and child lives during the pandemic period. Hence, programs and strategies designed to maintain maternal health services particularly, antenatal care service have better take the above determinants into consideration.

scholarly journals Professional Commitment and Its Associated Factors among Institutional Delivery Services Providers in Public Health Facilities, In Shone District, Southern Ethiopia

2022 ◽  
Vol 5 (1) ◽  
pp. 01-08
Author(s):  
Melaku Wolde Anshebo ◽  
Tesfaye Gobeana Tessema ◽  
Yosef Haile Gebremariam
Keyword(s):  
Public Health ◽  
Institutional Delivery ◽  
Personal Characteristics ◽  
Obstetric Care ◽  
Health Facilities ◽  
Professional Commitment ◽  
Southern Ethiopia ◽  
Care Providers ◽  
Public Health Facilities ◽  
Delivery Services

Background: There is paucity of information on level of commitment among health professionals attending delivery service in public health facilities of low-income countries including Ethiopia. Hence, the aim of this study is to assess the level and factors associated with professional commitment among institutional delivery services providers at public health facilities in Shone District, Southern Ethiopia. Methods: A facility-based cross-sectional study design was conducted at primary level public health facilities in Shone District. All health facilities (one primary hospital and 7 health centers) were included in the study. Five hundred three study participants who fulfilled inclusion criteria in proportion to obstetric care providers in each public health facilities were selected by applying simple random sampling method. Self-administered Likert scale type of questionnaire was used. Data were analyzed using SPSS version 20. Bivariate and multivariable logistic regression analyses were done to see the association between dependent and explanatory variables. Results: The magnitude of professional commitment for obstetric care providers working in public health facilities of Shone district was 69.4%. In this study, those who worked at hospital, those who had positive attitude toward organizational commitment, and those who had positive attitude toward personal characteristics were 2.4, 2.3 and 1.76 times more likely committed to profession compared with their counterparts respectively. Conclusion: The professional commitment among institutional delivery service provision was medium as compared to other study finding. All health professional should manage their own personal characteristics to behave in good way to be committed for their profession. Organizational commitment had great influence on professional commitment.

scholarly journals ‘We just look at the well-being of the baby and not the money required’: a qualitative study exploring experiences of quality of maternity care among women in Nairobi’s informal settlements in Kenya

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036966 ◽  
Author(s):  
Jackline Oluoch-Aridi ◽  
Francis Wafula ◽  
Gilbert Kokwaro ◽  
Mary B Adam
Keyword(s):  
Qualitative Study ◽  
Health Facility ◽  
Maternity Care ◽  
Informal Settlement ◽  
Perceived Quality ◽  
Poor Quality ◽  
Health Facilities ◽  
Public Facility ◽  
Clinical Services

ObjectiveTo examine how women living in an informal settlement in Nairobi perceive the quality of maternity care and how it influences their choice of a delivery health facility.DesignQualitative study.SettingsDandora, an informal settlement, Nairobi City in Kenya.ParticipantsSix focus group discussions with 40 purposively selected women aged 18–49 years at six health facilities.ResultsFour broad themes were identified: (1) perceived quality of the delivery services, (2) financial access to delivery service, (3) physical amenities at the health facility, and (4) the 2017 health workers’ strike.The four facilitators that influenced women to choose a private health facility were: (1) interpersonal treatment at health facilities, (2) perceived quality of clinical services, (3) financial access to health services at the facility, and (4) the physical amenities at the health facility. The three barriers to choosing a private facility were: (1) poor quality clinical services at low-cost health facilities, (2) shortage of specialist doctors, and (3) referral to public health facilities during emergencies.The facilitators that influenced women to choose a public facility were: (1) physical amenities for dealing with obstetric emergencies and (2) early referral to public maternity during antenatal care services. Barriers to choosing a public facility were: (1) perception of poor quality clinical services, (2) concerns over security for newborns at tertiary health facilities, (3) fear of mistreatment during delivery, (4) use of unsupervised trainee doctors for deliveries, (5) poor quality of physical amenities, and (6) inadequate staffing.ConclusionThe study provides insights into decision-making processes for women when choosing a delivery facility by identifying critical attributes that they value and how perceptions of quality influence their choices.

scholarly journals Utilization of Institutional Delivery Service in a Predominantly Pastoralist Community of Northeast Ethiopia

1970 ◽  
Vol 28 (4) ◽  
Author(s):  
Mohammed Ahmed ◽  
Meaza Demissie ◽  
Araya Abrha Medhanyie ◽  
Alemayehu Worku ◽  
Yemane Berhane
Keyword(s):  
Secondary School ◽  
Health Facility ◽  
Institutional Delivery ◽  
Home Delivery ◽  
Sub Saharan Africa ◽  
Cultural Barriers ◽  
School Level ◽  
Multivariable Logistic Regression Analysis ◽  
Skilled Delivery ◽  
Sub Saharan

BACKGROUND: Maternal mortality is high in sub-Saharan Africa, and most deaths occur around childbirth. In Ethiopia, most births happen at home without skilled delivery attendants, and particularly, the least utilization of skilled delivery is recorded in Afar Region. The factors that influence this utilization are not well documented in the region where utilization has been low. The aim of this study was to determine the prevalence of utilization of institutional delivery and associated factors.METHODS: A cross-section study with pretested structural questionnaire was conducted from August 5 to September 27, 2015, among women who gave birth within 24 months preceding the survey. A multivariable logistic regression analysis was done to identify factors associated with utilization of institutional delivery.RESULTS: Out of the total 1842 women, only 339(18.4%) of mothers reported having delivered their youngest child at a health facility. Home delivery was preferred due to cultural norms, lowrisk perception, and distance from a health facility. The odds of delivering in a health facility were higher for mothers who attended at least four antenatal visits during the index pregnancy (AOR=3.08,95%CI=1.91-4.96), those whose husbands were educated to secondary school (AOR= 1.86, 95% CI=1.34-2.60), and those that had at least secondary school level education themselves (AOR=1.52, 95% CI=1.03-2.23).CONCLUSION: Utilization of institution delivery among Afar communities is very low, and less educated mothers are lagging behind. Women’s education and full attendance to antenatal care can help increase utilization of skilled delivery services. Qualitativestudies to identify socio-cultural barriers are also essential.

scholarly journals A study to assess receipt and utilization of janani suraksha yojana cash incentive among mothers in urban slums of Raipur city, Chhattisgarh, India

2019 ◽  
Vol 7 (12) ◽  
pp. 4768
Author(s):  
Divya Sahu ◽  
Shanta P. Khes Beck ◽  
G. P. Soni ◽  
Abha Ekka ◽  
Srishti Dixit ◽  
...  
Keyword(s):  
Health Facility ◽  
Institutional Delivery ◽  
Urban Slum ◽  
Cross Sectional Study ◽  
Home Delivery ◽  
Cross Sectional ◽  
Janani Suraksha Yojana ◽  
Private Health Facility ◽  
Cash Incentive ◽  
The Government

Background: Janani Suraksha Yojana (JSY) replaces the National Maternity Benefit Scheme. It was launched by the Government of India in April 2005. The aim was to reduce maternal and neonatal mortality by increasing institutional delivery by providing cash incentive to the beneficiaries as well as the link worker ASHA. Objectives of this study was to assess receipt of Janani Suraksha Yojana (JSY) cash incentive and to assess fields of utilization of Janani Suraksha Yojana (JSY) cash incentive.Methods: A Community based cross-sectional study was conducted among 384 mothers delivered within last one year in urban slum of Raipur city. Study centre was department of community medicine, Pt. J.N.M. medical college Raipur, Chhattisgarh. A pre-designed and pre-tested questionnaire was used to interview the study subjects.Results: Out of total 384 study subject’s cheque of JSY cash incentive was received by 70.83%. All (100%) beneficiaries who received cheque was stipulated amount as per JSY guideline. Reasons for not receiving cheque was no availability of BPL card for those who delivered in accredited private health facility. Other reasons were absconded after delivery, unaware of cash incentive, did not go back to get the cheque when called later, patient shifted to another ward. None of the study subjects who delivered at home received the cash incentive cheque. Realization of cheque was not done by 22.79% of study subjects due to complex procedure to open an account in bank. Cash incentive money was utilized in neonatal care, drugs, food, household activities and some deposited in bank.Conclusions: JSY scheme is definitely functioning well in terms of providing cash incentive cheque of JSY on delivery in Government Health facility. There is need to simplify the procedure to open an account so that beneficiaries can avail cash incentive money. There is need to address the problems to receive cheque in home delivery and accredited Private health facility in addition to motivation for institutional delivery.

scholarly journals A Qualitative Study of the Development and Utilization of Health Facility-based Immunization Microplans in Uganda.

2021 ◽  
Author(s):  
David Kaawa-Mafigiri ◽  
Constance Iradukunda ◽  
Catherine Atumanya ◽  
Michael Odie ◽  
Arielle Mancuso ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Facility ◽  
Planning Process ◽  
Health Workers ◽  
Immunization Coverage ◽  
Health Facilities ◽  
Optimal Development ◽  
Limited Knowledge ◽  
Catchment Areas ◽  
Development And Utilization

Abstract Background: In 2006, Uganda adopted the Reaching Every District strategy with the goal of attaining at least 80% coverage for routine immunizations in every district. The development and utilization of health facility/district immunization microplans is the key to the strategy. A number of reports have shown sub-optimal development and use of microplans in Uganda. This study explores factors associated with sub-optimal development and use of microplans in two districts in Uganda to pinpoint challenges encountered during the microplanning process.Methods: A qualitative study was conducted comparing two districts, Kapchorwa with low immunization coverage and Luwero with high immunization coverage. Data were collected through multilevel observation of health facilities, planning sessions and planning meetings; records review of microplans, micromaps, and meeting minutes; 57 interviews with health workers at the Ministry level and lower cadre health facility workers. Data were analyzed using NVivo 8 qualitative text analysis software. Transcripts were coded, memos and display matrices were developed to examine the process of developing and utilization of microplans, including experiences of health workers (implementers). Results: Three key findings emerged from this study. First, there are significant knowledge gaps about the microplanning process among health workers at all levels (community and district health facility and nationally). Limited knowledge about communities and program catchment areas greatly hinders the planning process by limiting the ability to identify hard-to-reach areas as well as prioritize areas according to need. Secondly, the microplanning tool is bulky and complex. Finally, microplanning is being implemented in the context of already over-tasked health personnel who have to conduct several other activities as part of their daily routines.Conclusions: In order to achieve quality improvement of the Reaching Every District campaign, the microplanning process should be revised. Health workers’ misunderstanding and limited knowledge about the microplanning process, especially at peripheral health facilities, coupled with the complex, bulky nature of the microplanning tool reduces the effectiveness of microplanning in improving routine immunization in Uganda. The study reveals the need to reduce the complexity of the tool and identify ways to train and support workers in the use of the revised tool, including support in incorporating the microplanning process into their busy schedules.

scholarly journals Socio-cultural factors favoring home delivery in Afar pastoral community, northeast Ethiopia: A Qualitative Study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Mohammed Ahmed ◽  
Meaza Demissie ◽  
Alemayehu Worku ◽  
Araya Abrha ◽  
Yamane Berhane
Keyword(s):  
Qualitative Study ◽  
Care Service ◽  
Health Care Service ◽  
Home Delivery ◽  
Cultural Factors ◽  
Health Facilities ◽  
Traditional Birth Attendants ◽  
Cultural Barriers ◽  
District Health ◽  
Birth Attendants

Abstract Background Despite expanding the number of health facilities, Ethiopia has still the highest home delivery services utilization. Health care service utilization varies between regions within the country. This study explored the socio-cultural factors influencing health facility delivery in a pastoralist region of Afar, Ethiopia. Methods An explorative qualitative study was conducted in October–December 2015. A total of 18 focus group discussions were conducted separately with mothers, male tribal leaders and religious leaders. In addition, 24 key informant interviews were conducted with Women’s Affairs Bureau and district health office experts and traditional birth attendants and all were selected purposively. Data were coded and categorized using open code software and analyzed based on a thematic approach. Results The social factors that affect the choice of delivery place include workload, lack of independence and decision-making power of women, and lack of substitute for childcare and household chores during pregnancy and childbirth. The cultural and spiritual factors include assuming delivery as natural process ought to happen at home, trust in traditional birth attendants, traditional practices during and after delivery and faithful to religion practice, besides, denial by health facilities to benign traditional and spiritual practices such as prayers and traditional food preparations to be performed over there. Conclusion Socio-cultural factors are far more than access to health centers as barriers to the utilization of health facilities for child birth. The provision of a maternity waiting home around the health facilities can alleviate some of these socio-cultural barriers.

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