Maternal Health Care Seeking Behavior of Nepalese Woman: A Perspective of Socio Ecological Model

Abstract

<jats:title>Abstract</jats:title> <jats:p><jats:bold>Background </jats:bold>Nepal has a very high Maternal Mortality Ratio (MMR) in the South Asian region partly owing to the low utilization of maternal health services. One of the leading causes for maternal death in the rural areas of Nepal is lack of awareness about mental health. The prominent objective of this study is to explore the influencing factors utilization of maternal health care service among Nepalese women.<jats:bold>Methods </jats:bold>This is a qualitative study performed in Kathmandu district at Tribhuvan University Teaching Hospital, in Nepal. In-depth interviews (IDIs) were administrated with 18 women with recent delivery case (within seven days). Furthermore, five Key-informants interview (KIIs) with their husbands was conducted. The data was thematically analyzed using content analysis, where Social-Ecological Model (SEM) was applied as a theoretical framework to lead thematic content.<jats:bold>Results </jats:bold>Women's knowledge, perception, decision-making autonomy in interpersonal level, mother-in-law and husband's role in intrapersonal level, employment organization in institutional level, peer groups, and neighbors in community level, and safe-motherhood program in policy level were influencing factors to obey adequate Maternal Health Care Seeking Behavior (MHCSB). Also, negligence of women in MHC check-up, inadequate health facilities, health facilities without maternal requirement and non availability gynecologist were observed as a core barrier for utilization of MHCSB.<jats:bold>Conclusions </jats:bold>There were numerous causes for not utilizing MHCSB: inadequate health facilities, health facilities without maternal services, and unavailability of gynecologist especially in health facilities of rural areas in Nepal. More health facilities should be built especially in remote areas and adequately equipped with maternal health services, drugs, and specialist. Further, existing health facilities should be promoted with overall maternal health care requirement with its specialist. Free MHCS should cover the cost of items required for delivery in addition to ANC, PNC check-up and institutional delivery.</jats:p>