An account for barriers and strategies in fulfilling women’s right to quality maternal health care: a qualitative study from rural Tanzania

Abstract

BackgroundTanzania has ratified and abides to legal treaties indicating the obligation of the state to provide essential maternal health care as a basic human right. Nevertheless, the quality of maternal health care is disproportionately low. The current study sets to understand maternal health services’ delivery from the perspective of rural health workers’, and to understand barriers for and better strategies for realization of the right to quality maternal health care.MethodsSemi-structured in-depth interviews were conducted, involving 11 health workers mainly; medical attendants, enrolled nurses and Assistant Medical Officers from primary health facilities in rural Tanzania. Structured observation complemented data from interviews. Interview data were analyzed using thematic analysis guided by the conceptual framework of the right to health.ResultsThree themes emerged that reflected health workers’ opinion towards the quality of health care services; “It’s hard to respect women’s preferences”, “Striving to fulfill women’s needs with limited resources”, and “Trying to facilitate women’s access to services at the face of transport and cost barriers”.ConclusionHealth system has left health workers as frustrated right holders, as well as dis-empowered duty bearers. This was due to the unavailability of adequate material and human resources, lack of motivation and lack of supervision, which are essential for provision of quality maternal health care services. Pregnant women, users of health services, appeared to be also left as frustrated right holders, who incurred out-of-pocket costs to pay for services, which were meant to be provided free.

Reasons for delay in seeking treatment among women with obstetric fistula in Tanzania: a qualitative study

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Lessons learned through respectful maternity care training and its implementation in Ethiopia: an interventional mixed methods study

“…Similar Kenyan and Tanzanian studies found that providers' ability and willingness to provide RMC was strongly related to how they perceived their work environment including the availability of adequate staff and supplies, career opportunities, support services, and pay [34,35]. A recent global meta-review indicated that shortage of manpower and lack of drugs and equipment were major bottlenecks to improving the quality of maternal and newborn health care [36].…”

Factors affecting early identification of pregnant women by community health workers in Morogoro, Tanzania

“…In a study of the barriers to quality maternal healthcare in Tanzania, authors discovered a lack of availability of adequate resources necessary to assist in a healthy delivery in health facilities. Such resources extended to human resources, as health facility workers were often over-worked resulting in disrespectful and/or abusive treatment for 19–28% of women seeking care at health facilities [20]. Given these conditions, it seems likely that women would be hesitant to disclose their pregnancy to someone they perceive as a part of this system.…”