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埃塞俄比亚利用产科护理服务的障碍:探索性定性研究。

Barriers Towards Obstetric Care Service Utilization in Ethiopia: An Explorative Qualitative Study.

机构信息

Hawassa University, College of Medicine and Health Sciences, Ethiopia.

Dire Dawa University, College of Medicine and Health Sciences, Ethiopia.

出版信息

Ethiop J Health Sci. 2023 Oct;33(Spec Iss 2):105-116. doi: 10.4314/ejhs.v33i2.4S.

Abstract

BACKGROUND

Obstetric care has been at the center of both global and national agendas. More than 50% of pregnant mothers are still preferring to give birth at home with some even after having full antenatal care. However, a few literatures looked at contributing factors for this problem but they are not conclusive and do not consider different sociocultural context of Ethiopia and different health service related barriers. Hence, the aim of this study was to explore barriers to obstetric care service utilization in Ethiopia using the socio-ecological model.

METHODS

Explorative qualitative study was employed involving key-informant interviews, in-depth interviews, and focus group discussions between October and December 2021; Individual, community, health system, and contextual barriers were explored. Atlas ti. Version 9 was used for analysis.

RESULT

Lack of awareness, unfavorable perception, lack of partner involvement, cultural barrier, shortage of supplies, poor infrastructure, provider-related factors, poor monitoring, and evaluation system, challenging topography, and conflict were the major barriers that hinder mothers from receiving obstetrics service in Ethiopia.

CONCLUSION

Lack of awareness, unfavorable perception, conflict, problems with health system structure and process, and cultural and geographical conditions were major barriers in Ethiopia. Therefore, packages of intervention is important to avail essential equipment, strengthening follow up system, create awareness, and increase access to health facilities is very important for service improvement by the government and non-governmental organizations. Additionally, implementing conflict resolution mechanism is important for addressing better obstetric service.

摘要

背景

产科护理一直是全球和国家议程的核心。尽管超过 50%的孕妇仍然选择在家中分娩,其中一些人甚至已经接受了全面的产前护理,但仍有一些文献探讨了导致这种情况的因素,但这些因素并不确定,也没有考虑到埃塞俄比亚不同的社会文化背景和不同的与卫生服务相关的障碍。因此,本研究旨在利用社会生态学模型探讨埃塞俄比亚利用产科护理服务的障碍因素。

方法

采用探索性定性研究方法,于 2021 年 10 月至 12 月期间进行了关键知情人访谈、深入访谈和焦点小组讨论;探讨了个体、社区、卫生系统和背景障碍。使用 Atlas ti 版本 9 进行分析。

结果

缺乏意识、不利看法、缺乏伴侣参与、文化障碍、供应品短缺、基础设施差、提供者相关因素、监测和评估系统不佳、地形挑战和冲突是阻碍埃塞俄比亚母亲获得产科服务的主要障碍。

结论

缺乏意识、不利看法、冲突、卫生系统结构和流程问题以及文化和地理条件是埃塞俄比亚的主要障碍。因此,干预措施的综合包对于提供必要的设备、加强后续系统、提高意识以及增加获得卫生设施的机会非常重要,以便政府和非政府组织改善服务。此外,实施冲突解决机制对于改善产科服务非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bb1/10859740/08d84b56a23e/EJHS3306-0105Fig1.jpg

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