延缓埃塞俄比亚东部利用产妇保健服务的因素:一项定性探索性研究。
Delaying factors for maternal health service utilization in eastern Ethiopia: A qualitative exploratory study.
机构信息
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia; Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia.
Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia.
出版信息
Women Birth. 2020 May;33(3):e216-e226. doi: 10.1016/j.wombi.2019.04.006. Epub 2019 May 3.
BACKGROUND
In Ethiopia, maternal health service utilization is still unacceptably low. The societal and cultural factors that constrain women from attending these services have not yet been sufficiently explored. Using qualitative methods, we aimed to explore the factors that delay maternal health service utilization in eastern Ethiopia.
METHOD
A total of 13 audio-recorded focus group discussions were conducted comprising 88 participants. We conducted separate group discussions with reproductive aged women, mothers-in-law, traditional birth attendants, husbands, and Health Extension Workers to capture their knowledge, practices, feelings, thoughts and attitudes towards maternal health service utilization. The recorded sessions were transcribed into the local language and then translated into English for analysis.
RESULT
The study identified a number of factors that may delay maternal health service utilization. Factors were grouped using the Three Delays model as a framework. Low level of awareness regarding need, poor involvement of husband, perceived absence of health problems, social power, community misperceptions and cultural restrictions, negative attitudes towards male midwives, acceptance of traditional birth attendants and poor social networking were Delay One factors. Lack of physical accessibility and high transportation costs were categorised as Delay Two factors for skilled birth care attendance. Perceived or experienced poor quality of care were categorised as Delay Three factors for both skilled birth and postnatal care utilization.
CONCLUSION
Despite the ongoing government measures to improve maternal health service utilization in Ethiopia, numerous factors continue to contribute to delays in service use, which in turn contribute to high maternal mortality.
背景
在埃塞俄比亚,孕产妇卫生服务的利用率仍然低得令人无法接受。限制妇女接受这些服务的社会和文化因素尚未得到充分探讨。本研究采用定性方法,旨在探讨埃塞俄比亚东部地区影响孕产妇卫生服务利用的因素。
方法
共进行了 13 次录音焦点小组讨论,参与者共 88 人。我们分别与育龄妇女、婆婆、传统助产妇、丈夫和健康促进工作者进行了小组讨论,以了解他们对孕产妇卫生服务利用的知识、实践、感受、想法和态度。记录的会议被转录为当地语言,然后翻译成英文进行分析。
结果
研究确定了一些可能导致孕产妇卫生服务利用延迟的因素。这些因素按照“三延误”模型进行分组。对需求的认识水平低、丈夫参与度差、认为不存在健康问题、社会权力、社区误解和文化限制、对男助产士的负面态度、对传统助产妇的接受度以及不良的社交网络都是“第一延误”因素。缺乏身体可达性和高交通成本被归类为获得熟练助产服务的“第二延误”因素。对服务质量的感知或体验不佳被归类为获得熟练分娩和产后护理的“第三延误”因素。
结论
尽管埃塞俄比亚政府一直在采取措施提高孕产妇卫生服务的利用率,但仍有许多因素导致服务利用延迟,进而导致孕产妇死亡率居高不下。