The uptake of skilled birth attendants’ services in rural Nepal: A qualitative study

Article English OPEN
Baral, Y.R. ; Skinner, J. ; Van Teijlingen, Edwin ; Lyons, K. (2016)

Aim and objective: The general aim of this research was to explore why women do or do not want to uptake Skilled Birth Attendants’ (SBAs) services during childbirth. The objective was to explore the factors affecting the uptake of SBAs’ services during childbirth in ruralNepal. Methods: Semi-structured interviews were conducted. The data were analysed using thematic analysis. Setting: The fieldwork was conducted in a rural area, in a western hill district of Nepal. Participants: Interviews were conducted with 24 married women aged 18-49, who had given birth during the three years prior to the time of interview. Sixteen women were SBA users and eight were non-SBA users. Eight relatives, such as husbands, and parents-in-law were also interviewed as key informants. Findings: Four themes were identified as affecting the uptake of skilled care during childbirth: (1) Women’s individual characteristics; (2) Choice of, and access to, SBA services; (3) Cultural practice, gender role and decision making; and (4) Attitude and quality of SBAs and the hospital environment. Conclusion: A wide range of factors affect the uttake of SBAs services. These include: lack of SBAs in rural areas; women’s autonomy; difficult terrain; widespread poverty and illiteracy; limited resources and traditional and cultural attitudes; and gender factors. However, to date, women’s experiences and preferences have been overlooked in service design and development. There is a need for specific maternity service development, based on women’s experiences and perceptions. The establishment of a fully trained cadre of midwives, operating according to a professional code of ethics, could improve the quality of care in the existing health care facilities.
  • References (44)
    44 references, page 1 of 5

    1. United Nations. The Millennium Development Goals Report. United Nations, New York, 2011.

    2. World Health Organisation, United Nations International Children's Emergency Fund, United Nations Fund for Population Activities & World Bank. Trends in maternal mortality: 1990 to 2010. WHO, Geneva, 2012.

    3. Koblinsky, M., Conroy, C. Kureshy, N. Stanton, ME. & Jessop, S. Issues in programming for safe motherhood. Mother Care Arlington, VA: John Snow Inc 2000.

    4. World Health Organization. Making pregnancy safer: The critical role of the skilled attendant. A joint statement by WHO, ICM & FIGO, Geneva, 2004.

    5. World Health Organisation. Achieving Millennium Development Goal 5: Target 5A and 5B on reducing maternal mortality and achieving universal access to reproductive health. Briefing note on achieving Millennium Development Goal (MDG) 5. Department of Reproductive Health and Research, WHO, Geneva, 2009.

    6. Hogan, MC., Foreman, KJ. Naghavi, M. Ahn, SY. Wang, M. Makela, SM. Lopez et al. Maternal mortality for 181 countries, 1980-2008: A systematic analysis of progress towards Millennium Development Goal 5. The Lancet, 2010, 375:1609-1623.

    7. Hussein. J., Bell, J. Iang, MD. Mesko, N. Amery, J. & Graham, W. An appraisal of the maternal mortality decline in Nepal. PLoS ONE, 2011, 6, 5.

    8. Pant, PD., Suvedi, BK. Pradhan, A. Hulton, L. Matthews, Z. & Maskey, M. Investigating recent improvements in maternal health in Nepal: Further analysis of the 2006 Nepal Demographic and Health Survey. Calverton, Maryland, USA: Macro International Inc, 2008.

    9. Nepal Demography and Health Survey. Nepal Demographic and Health Survey 2011. Nepal Ministry of Health and Population, New ERA, and ICF International, Calverton, Maryland, 2011.

    10. Witter, S., Khadka, S. Subedi, HN. & Tiwari, S. The national free delivery policy in Nepal: Early evidence of its effects on health facilities. Health Pol & Plan, 2011, 26, 2:84-91.

  • Metrics
    views in OpenAIRE
    views in local repository
    downloads in local repository

    The information is available from the following content providers:

    From Number Of Views Number Of Downloads
    Bournemouth University Research Online - IRUS-UK 0 61
Share - Bookmark