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首页> 美国卫生研究院文献>Elsevier Sponsored Documents >How a womans interpersonal relationships can delay care-seeking and access during the maternity period in rural Zambia: An intersection of the Social Ecological Model with the Three Delays Framework
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How a womans interpersonal relationships can delay care-seeking and access during the maternity period in rural Zambia: An intersection of the Social Ecological Model with the Three Delays Framework

机译：妇女的人际关系如何在赞比亚农村地区的产妇期间延误就医和获取机会：社会生态模型与三延误框架的交集

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To reduce maternal mortality, countries must continue to seek ways to increase access to skilled care during pregnancy and delivery. In Zambia, while antenatal attendance is high, many barriers exist that prevent women from delivering with a skilled health provider. This study explores how the individuals closest to a pregnant woman in rural Zambia can influence a woman's decision to seek and her ability to access timely maternity care. At four rural health centers, a free listing (n = 167) exercise was conducted with mothers, fathers, and community elders. Focus group discussions (FGD) (n = 135) were conducted with mothers, fathers, mothers-in-law, and community health workers (CHWs) to triangulate findings. We analyzed the FGD data against a framework that overlaid the Three Delays Framework and the Social Ecological Model. Respondents cited husbands, female relatives, and CHWs as the most important influencers during a woman's maternity period. Husbands have responsibilities to procure resources, especially baby clothes, and provide the ultimate permission for a woman to attend ANC or deliver at a facility. Female relatives escort the woman to the facility, assist during her wait, provide emotional support, assist the nurse during delivery, and care for the woman after delivery. CHWs educate the woman during pregnancy about the importance of facility delivery. No specific individual has the role of assisting with the woman's household responsibilities or identifying transport to the health facility. When husbands, female relatives, or CHWs do not fulfill their roles, this presents a barrier to a woman deciding to deliver at the health facility (Delay 1) or reaching a health facility (Delay 2). An intervention to help women better plan for acquiring the needed resources and identifying the individuals to escort her and those to perform her household responsibilities could help to reduce these barriers to accessing timely maternal care.
机译：为了降低孕产妇死亡率，各国必须继续寻求方法，以增加怀孕和分娩期间获得熟练护理的机会。在赞比亚，虽然产前出勤率很高，但存在许多障碍，阻碍了妇女向熟练的保健人员分娩。这项研究探讨了在赞比亚农村最接近孕妇的人如何影响妇女的寻求决定以及她获得及时产妇护理的能力。在四个农村保健中心，对母亲，父亲和社区长者进行了免费挂号（n = 167）。与母亲，父亲，岳母和社区卫生工作者（CHWs）进行了焦点小组讨论（FGD）（n = 135）。我们根据覆盖三个延迟框架和社会生态模型的框架分析了烟气脱硫数据。受访者认为丈夫，女性亲戚和CHW是妇女生育期间最重要的影响者。丈夫有责任采购资源，特别是婴儿服装，并为妇女参加ANC或在工厂分娩提供最终许可。女性亲戚陪同该妇女前往设施，在其等待期间提供帮助，提供情感支持，在分娩期间为护士提供帮助，并在分娩后照顾该妇女。社区卫生工作者在怀孕期间教育妇女关于提供设施的重要性。没有特定的人扮演协助妇女承担家庭责任或确定运送至医疗机构的角色。当丈夫，女性亲戚或CHW不能履行其职责时，这将对妇女决定分娩到医疗机构（延迟1）或到达医疗机构（延迟2）构成障碍。采取一项干预措施，以帮助妇女更好地计划以获得所需的资源，并确定要护送她和履行家庭责任的个人，可以帮助减少这些障碍，使她们无法及时获得孕产妇保健。

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