School of Public Health, Samara University, Samara, Ethiopia.
Addis Continental, Institute of Public Health, Addis Ababa, Ethiopia.
Reprod Health. 2019 Nov 21;16(1):171. doi: 10.1186/s12978-019-0833-3.
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.
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.
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.
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.
尽管埃塞俄比亚增加了卫生机构的数量，但它仍然拥有最高的家庭分娩服务利用率。医疗保健服务的利用率在该国各地区之间存在差异。本研究探讨了影响埃塞俄比亚阿法尔一个牧民地区医疗机构分娩的社会文化因素。
2015 年 10 月至 12 月进行了一项探索性定性研究。分别对母亲、男性部落领袖和宗教领袖进行了 18 次焦点小组讨论。此外，还与妇女事务局和区卫生办公室专家以及传统助产妇进行了 24 次关键知情人访谈，所有这些访谈都是有目的选择的。使用开放式编码软件对数据进行编码和分类，并根据主题方法进行分析。
影响分娩地点选择的社会因素包括工作量、女性缺乏独立性和决策权，以及在怀孕和分娩期间缺乏照顾儿童和家务的替代者。文化和精神因素包括认为分娩是自然过程，应该在家里进行，对传统助产妇的信任，分娩期间和之后的传统习俗以及对宗教习俗的虔诚，此外，卫生机构拒绝在那里进行祈祷和传统食物准备等良性传统和精神习俗。
社会文化因素远不止是获得卫生中心作为利用卫生设施进行分娩的障碍。在卫生设施周围提供产妇等候室可以缓解其中一些社会文化障碍。
