Tukur Ismail, Cheekhoon Chan, Tinsu Tin, Muhammed-Baba Tukur, Aderemi Ijaiya Munir'deen
Dept. of Social and Preventive Medicine, University of Malaya, Kuala-Lumpur, Malaysia.
Dept. of Sociology Usman-Danfodio Sokoto State, Nigeria.
Iran J Public Health. 2016 May;45(5):586-95.
In many sub-Saharan African countries the rate of antenatal care (ANC) has been increased but skilled birth attendance rate is still low. The objective of this study was to evaluate the reasons why women prefer home delivery when facility based delivery is available at minimal cost.
This study was conducted in Northwest Nigeria using a qualitative method (phenomenology) among five categories of women in April - May 2013. This study investigated different categories of women (those that never attend ANC nor deliver in the facility, those that attend ANC but delivered at home and those that delivered once in the facility but fail to return in subsequent deliveries, the in-laws and facilities staff).
Through focus group discussions and In-depth interviews several reasons why women are averse to hospital deliveries were identified. Women reported ignorance, abuse, illiteracy, and poverty, and low esteem, poor attitude of health workers, few working hours and some integrated health services like preventing mother to child transmission of HIV testing as deterrents, while cheap and accessible services were reasons for preference to traditional birth attendants.
The findings highlighted important entrenched barriers to facility deliveries among women, which is basically socio-cultural and economic. Therefore emphasis must be given to health education program to ensure comprehensive and target specific messages that will address individual needs of the groups.
在许多撒哈拉以南非洲国家，产前保健（ANC）的覆盖率有所提高，但熟练接生率仍然很低。本研究的目的是评估在以最低成本提供设施分娩服务的情况下，妇女仍选择在家分娩的原因。
2013年4月至5月，在尼日利亚西北部采用定性方法（现象学）对五类妇女进行了这项研究。该研究调查了不同类别的妇女（从未接受过产前保健也未在医疗机构分娩的妇女、接受过产前保健但在家分娩的妇女、曾在医疗机构分娩一次但后续分娩未再返回的妇女、姻亲和医疗机构工作人员）。
通过焦点小组讨论和深入访谈，确定了妇女不愿在医院分娩的几个原因。妇女们报告称，无知、虐待、文盲、贫困、自尊心低、医护人员态度恶劣、工作时间短以及一些综合保健服务（如预防母婴传播艾滋病毒检测）是阻碍因素，而价格便宜且可及的服务则是她们选择传统接生员的原因。
研究结果突出了妇女在设施分娩方面存在的重要且根深蒂固的障碍，这些障碍主要是社会文化和经济方面的。因此，必须重视健康教育项目，以确保提供全面且针对特定目标群体的信息，满足各群体的个体需求。
