Low use of rural maternity services in Uganda: Impact of women's status, traditional beliefs and limited resources
Low use of rural maternity services in Uganda: Impact of women's status, traditional beliefs and limited resources
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DOI：
10.1016/s0968-8080(03)02176-1
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发表时间：
2003-05-01
影响因子：
--
通讯作者：
Kyomuhendo, GB
中科院分区：
文献类型：
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作者：
Kyomuhendo, GB
在乌干达，尽管有良好的政策和协调一致的努力，但为提高产妇服务的质量和提供服务而锁定的资源和熟练的工作人员并没有增加妇女对这些服务的利用，也没有降低产妇的高死亡率。本文报告了2000年11月至2001年10月在乌干达西部农村地区霍马进行的一项研究，其目的是加强对为什么妇女在面临怀孕或分娩并发症时继续选择导致严重发病率甚至死亡的高风险选择的理解。研究结果表明，坚持传统的分娩习惯和信念是重要的因素，即怀孕是对耐力的考验，产妇死亡是一件令人难过但正常的事情。初级保健单位和转诊医院的使用，包括发生并发症时，只被认为是一种失败的选择。初级保健一级缺乏熟练的工作人员，在医院投诉虐待、忽视和治疗不佳，以及对手术原因缺乏了解，再加上保健工作者认为妇女无知，也解释了妇女不愿在保健机构分娩和寻求并发症护理的原因。需要采取适当的干预措施，解决农村母亲与正规保健系统之间的障碍，包括对基本产科护理的所有方面进行社区教育，并提高服务提供者对农村母亲状况的认识。(C)2003年生殖健康问题。版权所有。
In Uganda, lock of resources and skilled staff to improve quality and delivery of maternity services, despite good policies and concerted efforts, have not yielded an increase in utilisation of those services by women or a reduction in the high ratio of maternal deaths. This paper reports a study conducted from November 2000 to October 2001 in Hoima, a rural district in western Uganda, whose aim was to enhance understanding of why, when faced with complications of pregnancy or delivery, women continue to choose high risk options leading to severe morbidity and even their own deaths. The findings demonstrate that adherence to traditional birthing practices and beliefs that pregnancy is a test of endurance and maternal death a sad but normal event, are important factors. The use of primary health units and the referral hospital, including when complications occur, was considered only as a lost resort. Lack of skilled staff at primary health care level, complaints of abuse, neglect and poor treatment in hospital and poorly understood reasons for procedures, plus health workers' views that women were ignorant, also explain the unwillingness of women to deliver in health facilities and seek care for complications. Appropriate interventions are needed to address the barriers between rural mothers and the formal health care system, including community education on all aspects of essential obstetric care and sensitisation of service providers to the situation of rural mothers. (C) 2003 Reproductive Health Matters. All rights reserved.