학술논문

Maternity waiting areas – serving all women? Barriers and enablers of an equity-oriented maternal health intervention in Jimma Zone, Ethiopia.
Document Type
Article
Source
Global Public Health. Oct2019, Vol. 14 Issue 10, p1509-1523. 15p.
Subject
*CHILDBIRTH
*COMMUNITY health workers
*CONTENT analysis
*DECISION making
*HEALTH attitudes
*HEALTH services accessibility
*HEALTH status indicators
*INTERVIEWING
*MATERNAL health services
*RESEARCH methodology
*PATIENT-family relations
*POPULATION geography
*QUESTIONNAIRES
*RESEARCH funding
*RURAL conditions
*STATISTICAL sampling
*SOCIAL networks
*SOCIAL values
*QUALITATIVE research
*CULTURAL values
*FAMILY relations
*PSYCHOSOCIAL factors
*DATA analysis software
*MEDICAL coding
*HEALTH & social status
Language
ISSN
1744-1692
Abstract
In Ethiopia, maternal waiting areas (MWAs) – residential areas near health facilities where women can stay while waiting to give birth – are community-based, equity-oriented interventions to improve maternal outcomes among rural populations. In this qualitative study we sought to explore the barriers and enablers that Health Extension Workers (HEWs) encounter when engaging with communities about MWAs. We conducted semi-structured interviews with HEWs across rural sites in Jimma Zone, Ethiopia. Drawing from an ecological model of social determinants of maternal and child health, we analysed data using thematic coding methods. HEWs reported a variety of factors that determined MWA use, including the number of children at home, previous childbirth experiences, community support networks, decision making practices within families, the availability and acceptability of health services, geographical access, and health beliefs. HEWs worked to increase the use of MWAs by engaging with husbands and communities, raising awareness in target groups of women, and managing community participation. Policies and practices that support enhanced training for HEWs, increased resources for communities, and greater opportunities for HEWs to liaise with decision makers at various levels of influence are possible ways forward to improve MWA use, specifically, and maternal and neonatal/child health outcomes more generally. [ABSTRACT FROM AUTHOR]