Toja Eshetu, Abebe Amene, Mekonen Niguse, Baza Daniel
Department of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Department of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Int J Womens Health. 2022 Jun 11;14:765-775. doi: 10.2147/IJWH.S365244. eCollection 2022.
Pregnant women who had full antenatal care follow-up are expected to give birth in health facilities. However, in Ethiopia, after full antenatal care booking, many women still prefer to give birth at home. Thus, the purpose of this study was to explore and describe why women give childbirth at home after full antenatal care follow-up in the study setting.
Exploratory-descriptive qualitative design was conducted in Humbo and Abala Abaya districts, Southern Ethiopia, from June to September 2020. Nine in-depth interviews and four focus group discussions were held with purposively selected participants. Women who gave birth at home after attending equal to or more than four antenatal care appointments in the last year were included. The collected data were majorly analyzed by inductive thematic analysis technique, but deductive analysis was also applied whenever the potential themes needed further enrichment. A thick description of the findings is done in the respective heading and sub-heading using participants' verbatim quotations.
A total of 9 in-depth interviews and four focus group discussions comprising 35 participants was conducted. Three major themes and nine sub-themes emerged from the data. Socio-cultural and community influences, socio-economic obstacles, and health system-related barriers are the major themes identified. Traditional practices, personal beliefs, social norms, knowledge, and attitude about institutional delivery, household economic capability, decision-making capacity of the women, delivery service quality, and service providers related barriers are the sub-themes defining the home delivery experience of women after full antenatal care follow-up in the study setting.
In this study, socio-economic, cultural, and health system-related barriers are major reasons for home delivery. Improvement of public awareness on the risk of home delivery and elimination of its facilitative social norms, empowerment of women's economic, educational, and decision-making capability and healthcare workers' and health facilities' capacity are recommended.
接受全程产前护理随访的孕妇预计会在医疗机构分娩。然而，在埃塞俄比亚，尽管进行了全程产前护理登记，许多女性仍然更倾向于在家分娩。因此，本研究的目的是探讨和描述在本研究环境中，女性在接受全程产前护理随访后仍在家分娩的原因。
2020年6月至9月，在埃塞俄比亚南部的洪博和阿巴拉阿巴亚地区开展了探索性描述性定性研究。对有目的地挑选出的参与者进行了9次深入访谈和4次焦点小组讨论。纳入了去年参加过四次及以上产前护理预约后仍在家分娩的女性。收集的数据主要采用归纳主题分析技术进行分析，但在潜在主题需要进一步充实的情况下也应用了演绎分析。使用参与者的逐字引语在相应的标题和子标题中对研究结果进行了详细描述。
共进行了9次深入访谈和4次焦点小组讨论，包括35名参与者。数据中出现了三个主要主题和九个子主题。确定的主要主题包括社会文化和社区影响、社会经济障碍以及与卫生系统相关的障碍。传统习俗、个人信仰、社会规范、对机构分娩的认知和态度、家庭经济能力、女性的决策能力、分娩服务质量以及与服务提供者相关的障碍是定义本研究环境中女性在接受全程产前护理随访后在家分娩经历的子主题。
在本研究中，社会经济、文化和与卫生系统相关的障碍是在家分娩的主要原因。建议提高公众对在家分娩风险的认识，消除其促成性社会规范，增强女性的经济、教育和决策能力以及医护人员和卫生设施的能力。
