Why do at-risk mothers fail to reach referral level? Barriers beyond distance and cost.
Why do at-risk mothers fail to reach referral level? Barriers beyond distance and cost.
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DOI：
10.2307/3583247
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发表时间：
2000-04-01
影响因子：
1
通讯作者：
Kimatta, S S
中科院分区：
文献类型：
--
作者：
Kowalewski, M;Jahn, A;Kimatta, S S
在坦桑尼亚南部，很少有高危妊娠通过产前护理转到转诊一级。我们研究了影响孕妇听从或拒绝转诊建议的因素。半结构化访谈60位准妈妈，26名卫生工作者和6名关键信息提供者，以确定使用转诊水平的障碍。专家定义的风险状态被发现对妇女寻求医院护理的决定几乎没有影响。除了众所周知的地理和经济障碍外，我们发现孕妇对危险信号有不同的看法和解释。此外，农村妇女因为害怕歧视而不去医院。我们的结论是，一个更个性化的产前咨询可以提供考虑到妇女的风险和他们的解释模型的看法。应重组医院服务，以解决农村妇女的恐惧和不安全感。
In southern Tanzania, few high-risk pregnancies are channeled through antenatal care to the referral level. We studied the influences that make pregnant women heed or reject referral advice. Semi-structured interviews with sixty mothers-to-be, twenty-six health workers and six key-informants to identify barriers to use of referral level were conducted. Expert-defined risk-status was found to have little influence on a woman's decision to seek hospital care. Besides well known geographical and financial barriers, we found that pregnant women have different perceptions and interpretations of danger signs. Furthermore, rural women avoid the hospital because they fear discrimination. We conclude that a more individualised antenatal consultation could be provided by taking into account women's perception of risk and their explanatory models. Hospital services should be reorganised to address rural women's feelings of fear and insecurity.