Improving access to skilled facility-based delivery services: Women's beliefs on facilitators and barriers to the utilisation of maternity waiting homes in rural Zambia.
Improving access to skilled facility-based delivery services: Women's beliefs on facilitators and barriers to the utilisation of maternity waiting homes in rural Zambia.
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DOI：
10.1186/s12978-015-0051-6
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发表时间：
2015-07-08
影响因子：
3.4
通讯作者：
Ruiter RA
中科院分区：
文献类型：
--
作者：
Sialubanje C;Massar K;van der Pijl MS;Kirch EM;Hamer DH;Ruiter RA
待产之家旨在改善农村地区获得基于设施的熟练接生服务的机会。这项研究探讨了赞比亚农村妇女在使用微波炉方面的经验和信念。需要深入了解妇女的经验和信仰，为设计公共卫生干预措施提供出发点，这些干预措施的重点是促进赞比亚农村地区获得和利用产妇保健和熟练助产服务。我们进行了32个深入的采访与育龄妇女（15-45岁）从9个卫生中心集水区。共有22个深入访谈进行了卫生保健设施与MWH和10个进行了卫生保健设施没有MWH。探讨了妇女对MWH的看法、关于使用MWH的决策过程以及影响MWH利用率的因素。大多数妇女赞赏产妇保健员在改善获得熟练助产护理和改善产妇保健结果方面发挥的重要作用。然而，妇女缺乏决策自主权、普遍存在的性别不平等、社会经济地位低下和社会文化规范等因素阻碍了她们利用这些服务。此外，没有资金购买婴儿和母亲在诊所分娩时使用的必需品，担心有亲戚留在家里照顾孩子，担心产妇和产妇状况差，缺乏基本的社会和保健需求----如足够的睡眠空间、被褥、水和卫生服务，食物和烹饪设施，以及护士和助产士不去探望住在产妇保健中心的母亲以确保她们的安全，这些都阻碍了妇女使用产妇保健中心。这些调查结果突出了干预措施的重要目标，并表明有必要向妇女提供技能和资源，以确保决策自主权，并解决降低其社会地位的普遍性别和文化规范。此外，有必要考虑提供基本的社会和保健需求，如充足的睡眠空间、床上用品、水和卫生服务、食品和烹饪设施，并确保护士和助产士定期探访住在产妇保健中心的母亲。
Maternity waiting homes (MWHs) are aimed at improving access to facility-based skilled delivery services in rural areas. This study explored women’s experiences and beliefs concerning utilisation of MWHs in rural Zambia. Insight is needed into women’s experiences and beliefs to provide starting points for the design of public health interventions that focus on promoting access to and utilisation of MWHs and skilled birth attendance services in rural Zambia. We conducted 32 in-depth interviews with women of reproductive age (15–45 years) from nine health centre catchment areas. A total of twenty–two in-depth interviews were conducted at a health care facility with a MWH and 10 were conducted at a health care facility without MWHs. Women’s perspectives on MWHs, the decision-making process regarding the use of MWHs, and factors affecting utilisation of MWHs were explored. Most women appreciated the important role MWHs play in improving access to skilled birth attendance and improving maternal health outcomes. However several factors such as women’s lack of decision-making autonomy, prevalent gender inequalities, low socioeconomic status and socio-cultural norms prevent them from utilising these services. Moreover, non availability of funds to buy the requirements for the baby and mother to use during labour at the clinic, concerns about a relative to remain at home and take care of the children and concerns about the poor state and lack of basic social and healthcare needs in the MWHs − such as adequate sleeping space, beddings, water and sanitary services, food and cooking facilities as well as failure by nurses and midwives to visit the mothers staying in the MWHs to ensure their safety prevent women from using MWHs. These findings highlight important targets for interventions and suggest a need to provide women with skills and resources to ensure decision-making autonomy and address the prevalent gender and cultural norms that debase their social status. Moreover, there is need to consider provision of basic social and healthcare needs such as adequate sleeping space, beddings, water and sanitary services, food and cooking facilities, and ensuring that nurses and midwives conduct regular visits to the mothers staying in the MWHs.
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影响因子：
2.4
作者：
Sialubanje, Cephas;Massar, Karlijn;Ruiter, Robert A C
通讯作者：
Ruiter, Robert A C
影响因子：
1
作者：
van Lonkhuijzen, Luc;Stegeman, Margreet;van Roosmalen, Jos
通讯作者：
van Roosmalen, Jos
影响因子：
4.2
作者：
Sheeran, P;Orbell, S
通讯作者：
Orbell, S
DOI：
10.1016/s0020-7292(97)00162-8
发表时间：
1997-11-01
影响因子：
3.8
作者：
Wilson, JB;Collison, AHK;Tinkorang, EK
通讯作者：
Tinkorang, EK
影响因子：
0.9
作者：
Agbla, F;Ergin, A;Boris, NW
通讯作者：
Boris, NW