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dc.contributor.authorPhiri, Selia Ng’anjoen_US
dc.contributor.authorFylkesnes, Knuten_US
dc.contributor.authorRuano, Ana Lorenaen_US
dc.contributor.authorMoland, Karen Marieen_US
dc.date.accessioned2014-09-18T13:41:15Z
dc.date.available2014-09-18T13:41:15Z
dc.date.issued2014-09-16eng
dc.identifier.issn1471-2393
dc.identifier.urihttps://hdl.handle.net/1956/8512
dc.description.abstractBackground: Maternal mortality remains high in sub-Saharan Africa. Health facility intra-partum strategies with skilled birth attendance have been shown to be most effective to address maternal mortality. In Zambia, the health policy for pregnant women is to have facility childbirth, but less than half of the women utilize the facilities for delivery. ‘Born before arrival’ (BBA) describes childbirth that occurs outside health facility. With the aim to increase our understanding of trust in facility birth care we explored how users and providers perceived the low utilization of health facilities during childbirth. Methods: A qualitative study was conducted in Kapiri Mposhi, Zambia. Focus group discussions with antenatal clinic and outpatient department attendees were conducted in 2008 as part of the Response to Accountable priority setting and Trust in health systems project, (REACT). In-depth interviews conducted with women who delivered at home, their husbands, community leaders, traditional birth attendants, and midwives were added in 2011. Information was collected on perceptions and experiences of home and health facility childbirth, and reasons for not utilizing a facility at delivery. Data were analysed by inductive content analysis. Results: Perspectives of users and providers were grouped under themes that included experiences related to promotion of facility childbirth, responsiveness of health care providers, and giving birth at home. Trust and quality of care were important when individuals seek facility childbirth. Safety, privacy and confidentiality encouraged facility childbirth. Poor attitudes of health providers, long distances and lack of transport to facilities, costs to buy delivery kits, and cultural ideals that local herbs speed up labour and women should exhibit endurance at childbirth discouraged facility childbirth. Conclusion: Trust and perceived quality of care were important and influenced health care seeking at childbirth. Interventions that include both the demand and supply sides of services with prioritizing needs of the community could substantially improve trust and utilization of facilities at childbirth, and accelerate efforts to achieve MDG5.en_US
dc.language.isoengeng
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.rights.urihttp://creativecommons.org/licenses/by/4.0eng
dc.subjectHome deliverieseng
dc.subjectHealth facility childbirtheng
dc.subjectBorn before arrivaleng
dc.subjectResponsivenesseng
dc.subjectZambiaeng
dc.title"Born before arrival": user and provider perspectives on health facility childbirths in Kapiri Mposhi district, Zambiaen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2014-09-18T07:04:35Z
dc.description.versionpublishedVersionen_US
dc.rights.holderSelia Ng’anjo Phiri et al.; licensee BioMed Central Ltd.
dc.rights.holderCopyright 2014 Ng’anjo Phiri et al.; licensee BioMed Central Ltd.
dc.source.articlenumber323
dc.identifier.doihttps://doi.org/10.1186/1471-2393-14-323
dc.identifier.cristin1165147
dc.source.journalBMC Pregnancy and Childbirth
dc.source.4014


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Med mindre annet er angitt, så er denne innførselen lisensiert som Attribution CC BY