Do Women in Rural Areas Still Prefer Homebirth with Traditional Birth Attendants? A Qualitative Study of Women in Rural Area of Kutai Kertanegara East Kalimantan (original) (raw)
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BMC Pregnancy and Childbirth, 2010
Background Trained birth attendants at delivery are important for preventing both maternal and newborn deaths. West Java is one of the provinces on Java Island, Indonesia, where many women still deliver at home and without the assistance of trained birth attendants. This study aims to explore the perspectives of community members and health workers about the use of delivery care services in six villages of West Java Province. Methods A qualitative study using focus group discussions (FGDs) and in-depth interviews was conducted in six villages of three districts in West Java Province from March to July 2009. Twenty FGDs and 165 in-depth interviews were conducted involving a total of 295 participants representing mothers, fathers, health care providers, traditional birth attendants and community leaders. The FGD and in-depth interview guidelines included reasons for using a trained or a traditional birth attendant and reasons for having a home or an institutional delivery. Results The use of traditional birth attendants and home delivery were preferable for some community members despite the availability of the village midwife in the village. Physical distance and financial limitations were two major constraints that prevented community members from accessing and using trained attendants and institutional deliveries. A number of respondents reported that trained delivery attendants or an institutional delivery were only aimed at women who experienced obstetric complications. The limited availability of health care providers was reported by residents in remote areas. In these settings the village midwife, who was sometimes the only health care provider, frequently travelled out of the village. The community perceived the role of both village midwives and traditional birth attendants as essential for providing maternal and health care services. Conclusions A comprehensive strategy to increase the availability, accessibility, and affordability of delivery care services should be considered in these West Java areas. Health education strategies are required to increase community awareness about the importance of health services along with the existing financing mechanisms for the poor communities. Public health strategies involving traditional birth attendants will be beneficial particularly in remote areas where their services are highly utilized.
PloS one, 2016
Although Bangladesh has made significant progress in reducing maternal and child mortality in the last decade, childbirth assisted by skilled attendants has not increased as much as expected. An objective of the Bangladesh National Strategy for Maternal Health 2014-2024 is to reduce maternal mortality to 50/100,000 live births. It also aims to increase deliveries with skilled birth attendants to more than 80% which remains a great challenge, especially in rural areas. This study explores the underlying factors for the major reliance on home delivery with Traditional Birth Attendants (TBA) in rural areas of Bangladesh. This was a qualitative cross-sectional study. Data were collected between December 2012 and February 2013 in Sunamganj district of Sylhet division and data collection methods included key informant interviews (KII) with stakeholders; formal and informal health service providers and health managers; and in-depth interviews (IDI) with community women to capture a range o...
Public Health of Indonesia, 2016
Background: Muna is the area where Bajo community prefer to choose shaman for giving birth Objectives: This study aims to determine the reasons why mothers choose shamans or midwives to give birth in Renda Village, Towea Subdistrict, Muna District.Methods: This was a descriptive qualitative study to investigate determinants of mother’s choice of place delivery in Renda Towea village of Muna, Indonesia. In-depth interview was performed to three mothers who gave birth with Shaman, and two mothers with Midwives. This study was conducted on July, 2016 in the village of Renda Towea, Muna district. Data were analyzed by content analysis model using Colaizzi’s method of data analysis.Results: Results were grouped into: Reasons to choose midwives to give birth (Health concern, Family support, and Complete facilities), and Reasons to select shaman to give birth (Tradition, Financial concern, Short distance, Lack of information)Conclusions: Various reasons of mothers in choosing maternal care...
Who are midwives and traditional birth attendants according to the users in the rural area
Background: Skilled traditional birth attendants as non-health workers (paraji) were risk factors for the incidence of maternal and perinatal mortality. Although the government has provided a birth insurance, rural communities still choose traditional birth attendant as their birth helper. The study aims at investigating women’s perceptions and experiences of birth helped by midwife and traditional birth attendant. Methods:The qualitative study with phenomenological approach were conducted through in-depth interviews using an interview guide. Data collection was conducted from June to July 2013 at Gajah Mekar Village, Kutawaringin District, Bandung Regency. Sampling was conductedusing purposive sampling technique. Total participants involved in this study were 12 women. Results:This study finds out that childbirth women distinguish maternity services provided by midwives and traditional birth attendants according to ages and appearances, beliefs/cultures, place of having birth, economic, delivery assistance, psychological and physical needs, post-natal care, and the danger/safety in childbirth. Conclusion:Strong culture in rural communities becomes an obstacle to equitable health care distribution. The government and related education institutions should collaborate in order to improve and enhance the quality of midwives and their services, so that birth assistances by traditional birth attendants can be suppressed.
Factors Associated With Home Maternal Deliveries in Rural Areas
Home maternal deliveries are deliveries conducted at home environment or any other place other than hospital. The MDG no. 5 targeted to increase women being attended by skilled health personnel to 90 %. In the year 2012-2013, 56 % of mothers in Kenya delivered at home and 488/100000 mothers died as a result of complications. Nakuru County recorded 58 % while Rongai had 73 % of the mothers who delivered at home. A case control study was conducted to find out the factors contributing to home maternal deliveries in Rongai. The objective of the study was to find out the factors influencing home maternal deliveries and data was collected using semi structured questionnaires where Stratified and purposive sampling methods were used to select subjects, 108 as cases and 42 as controls. Women between 19-49 years and brought their children for initial vaccination were included in the study. Filled questionnaires were analyzed using odds ratio and presented using frequency distribution tables and figures. The research findings indicated that knowledge, attitudes and practices during delivery were associated to home delivery. Lack of knowledge on safe delivery, negative attitude and bad practices influenced home delivery. The researcher recommends research on quality of hospital services.
BMC Pregnancy and Childbirth
Background: In low and middle-income countries, pregnancy and delivery complications may deprive women and their newborns of life or the realization of their full potential. Provision of quality obstetric emergency and childbirth care can reduce maternal and newborn deaths. Underutilization of maternal and childbirth services remains a public health concern in Tanzania. The aim of this study was to explore elements of the local social, cultural, economic, and health systems that influenced the use of health facilities for delivery in a rural setting in Northwest Tanzania. Methods: A qualitative approach was used to explore community perceptions of issues related to low utilization of health facilities for childbirth. Between September and December 2017, 11 focus group discussions were conducted with women (n = 33), men (n = 5) and community health workers (CHWs; n = 28); key informant interviews were conducted with traditional birth attendants (TBAs; n = 2). Coding, identification, indexing, charting, and mapping of these interviews was done using NVIVO 12 after manual familiarization of the data. Data saturation was used to determine when no further interviews or discussions were required. Results: Four themes emerge; self-perceived obstetric risk, socio-cultural issues, economic concerns and health facility related factors. Health facility delivery was perceived to be crucial for complicated labor. However, the idea that childbirth was a "normal" process and lack of social and cultural acceptability of facility services, made home delivery appealing to many women and their families. In addition, out of pocket payments for suboptimal quality of health care was reported to hinder facility delivery. Conclusion: Home delivery persists in rural settings due to economic and social issues, and the cultural meanings attached to childbirth. Accessibility to and affordability of respectful and culturally acceptable childbirth services remain challenging in this setting. Addressing barriers on both the demand and supply side could result in improved maternal and child outcomes during labor and delivery.
International Journal of Women's Health
Background: Uganda's maternal mortality remains unacceptably high, with thousands of women and newborns still dying of preventable deaths from pregnancy and childbirth-related complications. Globally, Antenatal care (ANC) attendance has been associated with improved rates of skilled births. However, despite the fact that over 95% of women in Uganda attend at least one ANC, over 30% of women still deliver at home alone, or in the presence of an unskilled birth attendant, with many choosing to come to hospital after experiencing a complication. We explored barriers to women's decisions to deliver in a health care facility among postpartum women in rural southwestern Uganda, to ultimately inform interventions aimed at improving skilled facility births. Methods: Between December 2018 and March 2019, we conducted in-depth qualitative face-to-face interviews with 30 post-partum women in rural southwestern Uganda. The purposeful sample was intended to represent women with differing experiences of pregnancy, delivery, and antenatal care. We included 15 adult women who had delivered from their homes and 15 who had delivered from a health facility in the previous 3 months. Women were recruited from 10 villages within 20 km of a regional referral hospital. Interviews were conducted and digitally recorded in a private setting by a trained native speaker to elicit experiences of pregnancy and birth. Translated transcripts were generated and coded. Coded data were iteratively reviewed and sorted to derive descriptive categories using an inductive content analytic approach. Results: Regardless of where they decided to give birth, women wished to deliver in a supportive, respectful, responsive and loving environment. The data revealed six key barriers to women's decisions to deliver from a health care facility: 1) Fear of unresponsive care, fueling a fear of being neglected or abandoned while at the facility; 2) fear of embarrassment and mistreatment by health care providers; 3) low perception of risk associated with pregnancy and childbirth; 4) preferences for particular birthing positions and their outcome expectations; 5) perceived lack of privacy in public facilities; and 6) perceived poor clinical and interpersonal skills of health providers to adequately explain birthing procedures or support expectant or laboring women and their newborn. Conclusion: Anticipation of unsupportive, unresponsive, disrespectful treatment, and a perceived lack of tolerance for simple, non-harmful traditions prevent women from delivering at health facilities. Building better interpersonal relationships between patients and providers within health systems could reinforce trust, improve patient-provider interaction, and facilitate useful information transfer during ANC and delivery visits. These expectations are important considerations in developing supportive health care systems that provide acceptable patient-friendly care. These findings are indicative of the vital need for midwives and other health care providers to have additional training in the role of communication and dignity in delivery of quality health care.
Journal of Forensic Medicine, 2021
Background: The high rate of maternal and infant mortality in Indonesia in the past year can be influenced by the habits of the community who prefer Traditional Birth Attendants (TBAs) in the childbirth. In fact, TBAs are not health profession and do not have competency standards to assist with childbirth, thus increasing the risk of maternal and infant mortality. This article aimed to determine the influence of culture on the community’s habit of choosing TBAsor official village midwives (OVMs)in childbirth process in remote areas.Methods: A cross-sectional study was used. The respondents were mothers who gave birth in the last one year in one remote sub-district in Aceh. TBAs and official village midwiveswereobserved and indepth interviews were also conducted.Resultsand Discussions:The results of this study showed community attitudes about cultural influences during pregnancy, such as TBAs-assisted delivery is a cultural belief that must be followed.Hence, factors that influence ...
BMC Pregnancy and Childbirth
Background Mothers in rural Ethiopian communities prefer giving birth at home. In developing countries, traditional birth attendants play an important role in reducing the maternal mortality rate. In Ethiopia, however, their role during pregnancy, childbirth, the postnatal period, and their integration with health professionals is not clearly defined. This study aimed to explore the role of traditional birth attendants in feto-maternal care during pregnancy, childbirth, and the postnatal period, and integration with health professionals in the West Omo Zone, southern Ethiopia. Methods A qualitative descriptive design was used with triangulation of methods and data sources. We conducted in-depth interviews with traditional birth attendants, key informant interviews with health care professionals and community or religious leaders, and two focus group discussions with multiparous pregnant women. Each interview and focus group discussion was tape-recorded and the data obtained were tra...
Journal of College of Medical Sciences-Nepal, 2010
Increasing the proportion of births attended by skilled health providers is likely the key factor in reducing maternal and perinatal morbidity and mortality. Study objectives were to identify key factors influencing the utilization delivery services and stakeholders’ perceptions about these services. The study utilized focus group discussions and in-depth interviews with a diversity of community members users and nonusers , dalit women and health facility staffs to gain insights about the factors influencing use of trained attendants. Field researchers were trained to use FGD guides and interview schedules, and then gathered information on the perspectives of the women and their families and health staff. In Nawalparasi and Kapilvwastu we conducted a comparative study to compare on factors affecting the volume of delivery services.In Nawalparasi the deliveries in the pervious six months was relatively large number from hospital and PHCC whereas in Kapilvastu the delivery was in smal...