Somé Donmozoun Télesphore, Sombie Issiaka, Meda Nicolas
Société d'Etudes et de Recherche en Santé Publique, Ouagadougou (SERSAP), Burkina Faso.
West African Health Organization (WAHO), Bobo-Dioulasso, Burkina Faso.
Pan Afr Med J. 2014 May 12;18:43. doi: 10.11604/pamj.2014.18.43.2210. eCollection 2014.
Skilled attendance is one of the major strategies to curtail maternal mortality, specifically in developing countries. Despite the low level of equipment, it is only in health facilities that skilled care are provided during pregnancy and childbirth; but there are some barriers which prevent women to use health facilities for good care.
This study was carried out in Ouargaye where a skilled care initiative was implemented by Family care International with the aim to increase the skilled attendance at delivery and Diapaga, the control district. Thirty (30) In-depth interviews, 8 Focus group discussions and 6 non participant observations were carried out. Participants were women from 15-49 years. All the interviews were tape-recorded, transcribed and analysed line by line. NVIVO was used to manage the interviews.
Four types of barriers have been described by women; 1) the cultural barriers concern the low status of women in the two districts and some traditional beliefs which mean that women can not always decide to use health facility by themselves. 2) The geographical barrier is about the distance to reach health facility and the lack of transport means. 3) The financial barrier to pay care and drugs. 4) Bad organization of care and poor quality of care provided to women.
To minimize the risk of complications during pregnancy and childbirth, it is important that women use health facilities. The barriers described by women are not insurmountable but needed to be integrated in a global comprehensive health policy.
熟练接生是降低孕产妇死亡率的主要策略之一,在发展中国家尤为如此。尽管设备水平较低,但只有在医疗机构才能在孕期和分娩期间提供专业护理;然而,存在一些障碍阻碍妇女利用医疗机构获得优质护理。
本研究在瓦尔盖进行,国际家庭护理组织在该地实施了一项专业护理倡议,旨在提高分娩时的熟练接生率,同时以迪亚帕加作为对照地区。开展了30次深入访谈、8次焦点小组讨论和6次非参与性观察。参与者为15至49岁的女性。所有访谈均进行录音、转录并逐行分析。使用NVIVO软件管理访谈。
女性描述了四种类型的障碍;1)文化障碍涉及两个地区女性地位低下以及一些传统观念,这意味着女性往往无法自行决定使用医疗机构。2)地理障碍是指前往医疗机构的距离以及缺乏交通方式。3)支付护理和药品费用的经济障碍。4)护理组织不善以及为女性提供的护理质量不佳。
为将孕期和分娩期间并发症的风险降至最低,女性使用医疗机构非常重要。女性所描述的障碍并非无法克服,但需要纳入全球综合卫生政策之中。