Background Home delivery (HD) without skilled birth attendants (SBAs) are considered crucial risk factors increasing maternal and child mortality rates in Loa PDR. While a few studies in the literature discuss the choice of delivery in remote areas of minority ethnic groups; our work aims to identify factors that indicated their delivery place, at home or in the health facilities. Methods A community-based qualitative study was conducted between February and March 2020. Three types of interviews were implemented, In-depth interviews with 16 women of eight rural villages who delivered in the last 12 months in Xepon District, Savannakhet Province, Lao PDR. Also, three focus group discussions (FGDs) with nine HCPs and key-informant interviews of ten VHVs were managed. Factors affecting the choice of the delivery place were categorized according to the social-ecological model. Results Our sample included five Tri women and two Mangkong women in the HD group, while the FD group included three Tri women, two Mangkong women, one Phoutai woman, two Laolung women and one Vietnamese. Our investigation inside the targeted minority showed that both positive perceptions of home delivery (HD) and low-risk perception minorities were the main reasons for the choice of HD, on the individual level. On the other hand, fear of complication, the experience of stillbirth, and prolonged labour pain during HD were reasons for facility-based delivery (FD). Notably, the women in our minority reported no link between their preference and their language, while the HCPs dated the low knowledge to the language barrier. On the interpersonal level, the FD women had better communication with their families, and better preparation for delivery compared to the HD group. The FD family prepared cash and transportation using their social network. At the community level, the trend of the delivery place had shifted from HD to FD. Improved accessibility and increased knowledge through community health education were the factors of the trend. At the societal (national policy) level, the free delivery policy and limitation of HCPs’ assisted childbirth only in health facilities were the factors of increasing FD, while the absence of other incentives like transportation and food allowance was the factor of remaining of HD. Conclusions Based on the main findings of this study, we urge the enhancement of family communication on birth preparedness and birthplace. Furthermore, our findings support the need to educate mothers, especially those of younger ages, about their best options regarding the place of delivery. We propose implementing secondary services of HD to minimize the emergency risks of HD. We encourage local authorities to be aware of the medical needs of the community especially those of pregnant females and their right for a free delivery policy.
The purpose ofthis paper is to grasp the roles played by community centers called " KOMINKAN " and the contents of events held in them . There are two types of events held in KOMINKAN ; one is sponsored by KOMINKAN itselfand Ihe other is planncd and performed by residents , Nara city was selected as a typical city in suburbs within commuting area fbr Osaka − city , and the f ()mer events were paid attention to. KOMINKANs are characterized by analyzing the types of events and the location of KOMINKAN in which they wcre played . There are 21 KOM1NKANs in Nara − city . We got information about events in all KOMINKAN from the data published by Nara − city and by a questionnaire about events . The results are summarized as fbllows . 1) In the areas of small population , more events are sponsored by KOMINKAN . KOMiNKAN have sponsored many events . to reduce the decrease in population a皿 t to activate thc area , 2) Popular events which many people participate show regional characteristics ofNara − city and are useful in actual life ofpeople . However , there are Iess popuiar events . KOMINKAN have to grasp needs ofpeople and to provide the events suitable fbr needs ofpeop ] e . 3) People demand the events which all of them can pa 面 cipate in as they want and which are per 恥 med by a popular , prominent person . Keywords ' Community centers ca 〃ed ' 」 KOMINKAN " , eientS sponsored by KOMINIL4N, needs / br events , situation Ofapρlicants
1 ) Thc 丘equency of a 皿 ounc 血 g in the magazine is related to the characteristics ofhalls ,2 ) The s辻u旧 tion of ente q 鵬 played in the halls with high announc 血 9 廿equency di偸 r among perf ( ) rming categories , and 3 ) Tlte halls With high anmouncing frequency tend to be used f( )r one perfbrming category , while the halls with 重 he less frequency are used for many kinds ofentertainments . κ騨 ぬ 'H 訓1鯔 d・s. ・n 舳 ち帥 m 9 t・ 9 ・ri ・・,
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