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首页> 外文期刊>BMC Pregnancy and Childbirth >Exploring barriers to the use of formal maternal health services and priority areas for action in Sidama zone, southern Ethiopia
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Exploring barriers to the use of formal maternal health services and priority areas for action in Sidama zone, southern Ethiopia

机译：探索在埃塞俄比亚南部西达玛地区使用正规产妇保健服务和优先行动领域的障碍

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In 2015 the maternal mortality ratio for Ethiopia was 353 per 100,000 live births. Large numbers of women do not use maternal health services. This study aimed to identify factors influencing the use of maternal health services at the primary health care unit (PHCU) level in rural communities in Sidama zone, south Ethiopia in order to design quality improvement interventions. We conducted a qualitative study in six woredas in 2013: 14 focus group discussions (FGDs) and 44 in-depth interviews with purposefully selected community members (women, male, traditional birth attendants, local kebele administrators), health professionals and health extension workers (HEWs) at PHCUs. We digitally recorded, transcribed and thematically analysed the interviews and FGDs using Nvivo. The ‘three delay model’ informed the analytical process and discussion of barriers to the use of maternal health services. Lack of knowledge on danger signs and benefits of maternal health services; cultural and traditional beliefs; trust in TBAs; lack of decision making power of women, previous negative experiences with health facilities; fear of going to an unfamiliar setting; lack of privacy and perceived costs of maternal health services were the main factors causing the first delay in deciding to seek care. Transport problems in inaccessible areas were the main contributing factor for the second delay on reaching care facilities. Lack of logistic supplies and equipment, insufficient knowledge and skills and unprofessional behaviour of health workers were key factors for the third delay in accessing quality care. Use of maternal health services at the PHCU level in Sidama zone is influenced by complex factors within the community and health system. PHCUs should continue to implement awareness creation activities to improve knowledge of the community on complications of pregnancy and benefits of maternal health services. The health system has to be responsive to community’s cultural norms and practices. The mangers of the woreda health office and health centres should take into account the available budgets; work on ensuring the necessary logistics and supplies to be in place at PHCU.
机译：2015年，埃塞俄比亚的产妇死亡率为每10万活产353。大量妇女不使用产妇保健服务。这项研究旨在确定影响埃塞俄比亚南部西达玛地区农村社区初级卫生保健单位（PHCU）使用孕产妇保健服务的因素，以便设计质量改善干预措施。 2013年，我们在6个世界观中进行了定性研究：14次焦点小组讨论（FGD）和44次针对特定目标社区成员（妇女，男性，传统接生员，当地凯贝勒行政管理人员），卫生专业人员和卫生推广人员的深入访谈（ HEWs）。我们使用Nvivo对采访和FGD进行了数字记录，转录和主题分析。 “三延迟模型”为分析过程和使用产妇保健服务的障碍进行了讨论。对孕产妇保健服务的危险迹象和益处缺乏了解;文化和传统信仰;信任TBA;缺乏妇女的决策权，以前在保健设施方面的负面经历;害怕去一个陌生的环境;缺乏隐私和产妇保健服务的可感知成本是导致决定寻求护理的第一时间延迟的主要因素。人迹罕至地区的交通问题是造成第二次延误到达护理设施的主要原因。缺少后勤物资和设备，知识和技能不足以及卫生工作者的不专业行为是导致第三次延误获得优质医疗服务的关键因素。 Sidama地区PHCU级别的产妇保健服务的使用受到社区和卫生系统内复杂因素的影响。 PHCU应继续开展提高意识的活动，以提高社区对妊娠并发症和孕产妇保健服务的了解。卫生系统必须顺应社区的文化规范和惯例。沃达医疗办公室和医疗中心的管理人员应考虑可用预算;确保在PHCU部署必要的物流和物资。

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