Seljeskog Line, Sundby Johanne, Chimango Jane
University of Oslo, Norway.
Afr J Reprod Health. 2006 Dec;10(3):66-75.
This explorative study was conducted in the Mangochi area in Malawi with the aim of investigating the individual, community and health facility level factors influencing women's choice of place of delivery. In depth interviews and non-participating observation were the methods used. Three major issues were revealed. First, sub optimal quality of care including communication, attitudes and cooperation within the health care system was identified as a main factor. Secondly, cultural aspects such as influence from decision makers, perceptions of danger signs and traditional views on pregnancy and delivery were important. Finally, an unsatisfactory availability to skilled delivery care in terms of distance, transport and costs was shown. We conclude that the barriers to use of professional obstetric care in Malawi partly can be attributed to the health care system itself, and that a more individualized maternity care is needed.
这项探索性研究在马拉维的曼戈奇地区开展，旨在调查影响妇女分娩地点选择的个人、社区及卫生设施层面的因素。采用的方法是深度访谈和非参与式观察。研究揭示了三个主要问题。首先，医疗保健系统内包括沟通、态度及合作在内的护理质量欠佳被认定为主要因素。其次，诸如决策者的影响、对危险信号的认知以及关于怀孕和分娩的传统观念等文化因素很重要。最后，在距离、交通和费用方面，获得熟练接生护理的情况不尽人意。我们得出结论，马拉维使用专业产科护理的障碍部分可归因于医疗保健系统本身，并且需要更具个性化的孕产妇护理。
