School of Nursing, Faculty of Health Sciences, Institute of Health Science, Jimma University, Jimma, Ethiopia.
Department of Health, Behavior and Society, Ethiopian Evidence Based Health Care Centre, Institute of Health, Jimma University, Jimma, Ethiopia.
BMC Womens Health. 2023 Feb 24;23(1):83. doi: 10.1186/s12905-023-02207-4.
Continuum of care for Maternal Health Care is continuity of care through pregnancy, childbirth, and after birth as a key strategy in reaching mothers and babies at a crucial time. Despite the widespread drop out from the continuum of care, there is limited understanding of perspectives of providers and clients about factors leading to drop out from care among women in Ethiopia.
The aim of this study is to explore the underlying reasons for which women walk away from maternal health services in Ethiopia care providers' and clients' perspectives.
The population for the study were comprised of all purposefully selected district health department deputy heads, MCH coordinators, primary health center unit directors, midwives and nurses in charge of maternity department and who have been rendering maternal health services and chosen women among those attending the MCH clinic for maternal health services in order to identify reasons for dropout from the perspective of the service users based on the established criteria. The final sample size was determined based on the level of information saturation and a total of 20 in-depth interviewees were conducted. The unstructured key informant interview (KII) guide was used to collect data to gain an in-depth understanding of the context in which continuum of care for maternal health care takes place and existing barriers.
The main themes were identified and compared across all the transcripts to determine similarities and variations in the views of respondents. The major reasons for which women walk away from maternal health services were categorized under three main themes: healthcare system related reasons, community level barriers and individual level barriers. Interpretive analysis was conducted, and elucidations of the results follow the respective themes and verbatim that capture dominant views were considered wherever appropriate to substantiate the findings.
Women were walk away from maternal health services because of health system, community level and individual level factors. Hence, implementing initiatives to improve both providers and clients side barriers are essential. Furthermore, we recommend more large-scale studies to digging out more context specific barriers.
孕产妇保健连续护理是贯穿怀孕、分娩和产后的护理连续性，是在关键时刻接触母婴的关键策略。尽管普遍存在脱离连续护理的情况，但对于埃塞俄比亚妇女脱离护理的原因，提供者和客户的观点有限。
本研究旨在从提供者和客户的角度探讨妇女离开孕产妇保健服务的根本原因。
研究对象为所有经有目的地选择的地区卫生部门副主任、妇幼保健协调员、初级保健中心单位主任、负责妇产科的助产士和护士以及那些在妇幼保健诊所接受孕产妇保健服务的选择妇女，以便根据既定标准从服务使用者的角度确定脱离服务的原因。最终样本量根据信息饱和度水平确定，共进行了 20 次深入访谈。使用非结构化关键知情人访谈（KII）指南收集数据，以深入了解连续护理孕产妇保健服务发生的背景和现有障碍。
确定了主要主题，并对所有转录本进行了比较，以确定受访者观点的相似点和差异。妇女离开孕产妇保健服务的主要原因分为三个主要主题：医疗保健系统相关原因、社区层面障碍和个人层面障碍。进行了解释性分析，并按照各自的主题阐明结果，在适当的情况下考虑了捕捉主要观点的逐字记录，以证实研究结果。
妇女离开孕产妇保健服务是因为健康系统、社区层面和个人层面的因素。因此，实施旨在改善提供者和客户双方障碍的举措至关重要。此外，我们建议进行更多的大规模研究，以挖掘更多特定于背景的障碍。
