Department of Health Studies, University of South Africa, Addis Ababa, Ethiopia.
Department of Health Studies, University of South Africa, Pretoria, South Africa.
BMC Pregnancy Childbirth. 2020 Oct 19;20(1):633. doi: 10.1186/s12884-020-03312-0.
Having a birth attendant with midwifery skills during childbirth is an effective intervention to reduce maternal and early neonatal morbidity and mortality. Nevertheless, many women in Ethiopia still deliver a baby at home. The current study aimed at exploring and describing reasons why women do not use skilled delivery care in North West Ethiopia.
This descriptive explorative qualitative research was done in two districts of West Gojjam Zone in North West Ethiopia. Fourteen focus group discussions (FGDs) were conducted with pregnant women and mothers who delivered within one year. An inductive thematic analysis approach was employed to analyse the qualitative data. The data analysis adhered to reading, coding, displaying, reducing, and interpreting data analysis steps.
Two major themes client-related factors and health system-related factors emerged. Factors that emerged within the major theme of client-related were socio-cultural factors, fear of health facility childbirth, the nature of labour, lack of antenatal care (ANC) during pregnancy, lack of health facility childbirth experience, low knowledge and poor early care-seeking behaviour. Under the major theme of health system-related factors, the sub-themes that emerged were low quality of service, lack of respectful care, and inaccessibility of health facility.
This study identified a myriad of supply-side and client-related factors as reasons given by pregnant women, for not giving birth in health institution. These factors should be redressed by considering the specific supply-side and community perspectives. The results of this study provide evidence that could help policymakers to develop strategies to address barriers identified, and improve utilisation of skilled delivery service.
在分娩时拥有具备助产技能的接生员是减少产妇和新生儿发病率和死亡率的有效干预措施。然而，在埃塞俄比亚，仍有许多妇女在家中分娩。本研究旨在探讨和描述为什么在埃塞俄比亚西北部的妇女不使用熟练的分娩护理。
这是在埃塞俄比亚西北部的西戈贾姆地区的两个区进行的描述性探索性定性研究。对在一年内分娩的孕妇和产妇进行了 14 次焦点小组讨论（FGD）。采用归纳主题分析方法对定性数据进行分析。数据分析遵循阅读、编码、展示、减少和解释数据分析步骤。
出现了两个主要主题，即客户相关因素和卫生系统相关因素。在客户相关的主要主题下出现的因素包括社会文化因素、对医疗机构分娩的恐惧、分娩的性质、怀孕期间缺乏产前护理（ANC）、缺乏医疗机构分娩经验、知识水平低和早期寻求医疗保健的行为不佳。在卫生系统相关因素的主要主题下，出现的子主题包括服务质量低、缺乏尊重护理以及医疗机构难以到达。
本研究确定了一系列由孕妇给出的、不选择在医疗机构分娩的供应方和客户相关因素。这些因素应该从供应方和社区的具体角度来解决。这项研究的结果提供了证据，可以帮助政策制定者制定策略来解决确定的障碍，并提高熟练分娩服务的利用率。
