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Baral, Y.R.; Skinner, J.; Van Teijlingen, Edwin; Lyons, K. (2016)
Languages: English
Types: Article
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.
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    • 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.
    • 11. Pradhan, A., Subedi, BK. Barnett, S. Sharma, SK. Puri, M. Poudel, P. & Chitrakar Rai, S. KC, NP. & Hulton, L. Nepal maternal morbidity and mortality study 2008/2009. Family Health Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal, Programming for Safe Motherhood. Mother Care Arlington, VA: John Snow Inc, 2010.
    • 12. Futura, M., & Salway, S. Women's position within the household as a determinant of maternal health care use in Nepal. Int Fam Plan Persp, 2006, 32, 1:17-27.
    • 13. Wagle, RR., Sabroe, S. & Nielsen, BB. Socio-economic and physical distance to the maternity hospital as predictors for place of delivery: An observation study from Nepal. BMC Pregnancy Childbirth, 2004, 4, 8.
    • 14. Matsumura, M., & Gubhaju, B. Women's status, household structure and the utilisation of maternal health services in Nepal. Asia Pac Pop J, 2001, 16, 1: 23-44.
    • 15. Baral, YR., Lyons, K. Skinner, J. & van Teijlingen, ER. Determinants of skilled birth attendants for delivery in Nepal. Kathmandu Uni Med J, 2010, 8, 3: 325-332.
    • 16. Baral, YR., Lyons, K. Skinner, J. & van Teijlingen, ER. Maternal health services utilisation in Nepal: Progress in the new millennium? Health Sci J, 2012, 6, 4:618- 633.
    • 17. Borghi, J., Ensor, T. Neupane BD. & Tiwari, S. Financial implications of skilled birth attendance at delivery in Nepal. Trop Med Int Health, 2006, 11, 2: 228-237.
    • 18. Acharya, LB., & Cleland, J. Maternal and child health services in rural Nepal: Does access or quality matter. Health Pol Plan, 2000, 15, 2: 223-229.
    • 19. Sharma, S. Reproductive rights of Nepalese women current status and future directions. Kathmandu Uni Med J, 2004, 2, 1: 52-54.
    • 20. District Profile. District development committee, information, and data collection centre, Kaski District Health Services, Pokhara, Nepal, 2011.
    • 21. Bogren, MU., Van Teijlingen, ER. & Berg, M. Where midwives are not yet recognized: A feasibility study professional midwives in Nepal. Midwifery, 2013, 29, 10:1103-1109.
    • 22. D'Ambruoso, L., Abbey, M. & Hussein, J. Please understand when I cry out in pain: Women's accounts of maternity services during labour and delivery in Ghana. Public Health, 2005, 5:140.
    • 23. Bryman, A. Social research methods, (4th edn.). Oxford University Press, Oxford, 2012.
    • 24. Harris, FM., van Teijlingen, ER. Hundley, V. Farmer, J. Bryers, H. Caldow, J. et al. The buck stops here: Midwives and maternity care in rural Scotland. Midwifery, 2011, 27, 3: 301-307.
    • 25. Belgrave, LL., Zablotsky, D. & Guadagno, MA. How do we talk to each other? Writing qualitative research for quantitative readers. Qual Health Res, 2002, 12, 10: 1427-1439.
    • 26. Van Teijlingen, ER. & Hundley,V. Pilot studies in family planning and reproductive health care. J Fam Plan Reprod Health Care, 2005, 31, 3: 219-221.
    • 27. Twinn, S. An exploratory study examining the influence of translation on the validity and reliability of qualitative data in nursing research. J Adv Nurs, 1997, 26, 2: 418- 423.
    • 28. Small, R., Yelland, J. & Lumley, J. Cross-cultural research: Trying to do it better. 2. Enhancing data quality. Aust NZ J Public Health, 1999, 23, 4:390-395.
    • 29. Kirkpatrick, P. & van Teijlingen, ER. Lost in Translation: Reflecting on a Model to Reduce Translation and Interpretation Bias. Open Nur J, 2009, 3, 25-32.
    • 30. Thomas, J., & Harden, A. Methods for the thematic synthesis of qualitative research in systematic reviews. National Centre for Research Methods Working Paper Series Number (10/07), London, 2007.
    • 31. Central Bureau Statics. Population monograph of Nepal. Central Bureau of Statistics, Vol. 1, Kathmandu, Nepal, 2003.
    • 32. Manadhar, M. Ethnographic perspectives on obstetric health issues in Nepal. A literature review. Nepal safer motherhood project. Department of Health Services, Ministry of Health and Department of International Development, Kathmandu, Nepal, 2000.
    • 33. Acharya, M. Gender equality and empowerment of women in Nepal. UNFPA, Kathmandu, Nepal, 2007.
    • 34. Mumtaz, Z., & Salway, SM. Understanding gendered influences on women's reproductive health in Pakistan: Moving beyond the autonomy paradigm. Soc Sci Med, 2009, 68, 7:1349-1356.
    • 35. Bennett, L., Dahal, DR. & Govindasamy, P. Caste, ethnic and regional identity in Nepal: Further analysis of the 2006 Nepal Demographic and Health Survey. Calverton, Maryland, USA: Macro International Inc, 2008.
    • 36. Central Intelligence Agency. The world facts book. Nepal economy overview. Available in http://www.indexmundi.com/nepal/economy_overview.html, accessed February, 2013.
    • 37. Government of Nepal. Women development programme annual progress report, 2010-2011. Women Children and Social Welfare Ministry, Department of Women and Children, Shreemahal, Lalitpur, Nepal, 2012.
    • 38. Mullany, CB., Becker, S. & Hindin, MJ. The impact of including husbands in antenatal health education services on maternal health practices in urban Nepal: Results from a randomized controlled trial. Health Edu Res, 2007, 22, 2:166-176.
    • 39. Sapkota. S., Kobayashi, T. & Takase, M. Husband's experiences of supporting their wives during childbirth in Nepal. Midwifery, 2012, 28: 45-51.
    • 40. Mumtaz, Z., & Salway, S. Gender, pregnancy and uptake of antenatal care services in Pakistan. Sociol Health Illness, 2007, 29, 1:1-26.
    • 41. Redshaw, M., & Heikki, K. Delivered with care: A national survey of women's experience of maternity care 2010. The National Perinatal Epidemiology Unit, University of Oxford, Oxford, 2010.
    • 42. Choulagai, B., Onta, S. Subedi, N. Mehata, S. Bhandari, GP. Poudyal, A. et al. Barriers to using skilled birth attendants' services in mid-and far-western Nepal: A cross-sectional study. BMC Int Health Human Rights, 2013, 13:49.
    • 43. Devkota, B., & van Teijlingen, ER. Understanding effects of armed conflict on health outcomes: The case of Nepal. Conflict Health, 2010, 4, 20.
    • 44. Bowser, D., & Hill, K. Exploring evidence for disrespect and abuse in facility based childbirth: Report of a landscape analysis. Bethesda, MD: USAID Traction Project, University Research Corporation, LLC, and Harvard School of Public Health, 2010
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