Shiferaw Biruhtesfa Bekele, Modiba Lebitsi Maud
Department of Health Studies, University of South Africa, Pretoria, South Africa.
Obstet Gynecol Int. 2020 Feb 10;2020:8207415. doi: 10.1155/2020/8207415. eCollection 2020.
Skilled attendance at birth is widely regarded as an effective intervention to reduce maternal and early neonatal morbidity and mortality. However, many women in Ethiopia still deliver without skilled assistance. This study was carried out to identify factors that influenced or motivated women to give birth in a health facility in their previous, current, and future pregnancies. This descriptive explorative qualitative study was conducted in two districts of West Gojjam zone in North West Ethiopia. Fourteen focus group discussions were conducted with pregnant women and women who gave birth within one year. An inductive thematic analysis approach was employed to analyze the qualitative data. In this study, two major themes and a number of subthemes emerged from the focus group discussions with the study participants. The factors that influenced or motivated women to give birth in health facility in their previous, current, and future pregnancies include access to ambulance transport service, prevention of mother to child HIV transmission service, referral service, women friendly service, and emergency obstetric services, good interpersonal care from health workers, and fear and experience of obstetric danger signs and complications. In addition, reception of information and advice on importance of skilled delivery care and obstetric danger signs and complications from health workers, use of antenatal care, previous use of skilled delivery care, ensuring wellbeing of parturient women and newborns, and use of emergency obstetric care were also identified as influencers and motivators for health facility childbirth in previous, current, and future deliveries. Increased understanding of the factors that influenced or motivated women to deliver in facilities could contribute to developing strategies to improve the uptake of facility-based maternity services and corresponding declines in maternal morbidity and mortality.
熟练的接生服务被广泛认为是降低孕产妇和早期新生儿发病率及死亡率的有效干预措施。然而，埃塞俄比亚的许多妇女仍然在没有熟练助产人员协助的情况下分娩。本研究旨在确定影响或促使妇女在其既往、当前及未来妊娠期间选择在医疗机构分娩的因素。这项描述性探索性定性研究在埃塞俄比亚西北部戈贾姆西区的两个县开展。与孕妇及产后一年内的妇女进行了14次焦点小组讨论。采用归纳主题分析法对定性数据进行分析。在本研究中，与研究参与者进行的焦点小组讨论产生了两个主要主题和若干子主题。影响或促使妇女在其既往、当前及未来妊娠期间选择在医疗机构分娩的因素包括获得救护车运输服务、预防母婴艾滋病毒传播服务、转诊服务、对妇女友好的服务、急诊产科服务、医护人员良好的人际关怀，以及对产科危险信号和并发症的恐惧及经历。此外，从医护人员处获得关于熟练接生护理以及产科危险信号和并发症重要性的信息和建议、产前护理的使用、既往对熟练接生护理的使用、确保产妇和新生儿的健康，以及急诊产科护理的使用，也被确定为既往、当前及未来分娩时选择在医疗机构分娩的影响因素和动机。增强对影响或促使妇女在医疗机构分娩的因素的理解，有助于制定策略以提高基于医疗机构的孕产妇服务的利用率，并相应降低孕产妇发病率和死亡率。
