Utilization of rural maternity delivery services in Nawalparasi and Kapilvastu District: A Qualitative Study

Abstract

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 smaller number. The vast majority of women planned to have a home delivery attended by relatives and/or a Trained Birth Attendants and to reserve attendance at a health facility as a back-up plan in case of prolonged labor and complications. Ritual pollution considerations interfere with a decision to seek delivery in a facility, especially in the Western Hills. The cost recovery scheme ("incentives") deals with a major factor which inhibits use of health facilities. TBAs can encourage clients to deliver in health facilities. Staff feel that the large number of vacant positions inhibits availability of services and requires strenuous efforts on their part to cover for vacancies. Key Words: Maternity; delivery; health staff DOI: 10.3126/jcmsn.v6i3.4072Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.29-36

Childbirth traditions and cultural perceptions of safety in Nepal: Critical spaces to ensure the survival of mothers and newborns in remote mountain villages

“…This is despite the practice being seen as medically risky with infection and neonatal deaths (eg Ahmed et al, 2010;Thapa et al, 2001;Regmi and Madison, 2009). Women in this study affirmed traditions and beliefs as positive contributors to their safety and survival and likewise their babies during pregnancy and birth.…”

“…Additionally, the medical interpretation of childbirth does not acknowledge existent traditional birthing practices which subsequently influence use of medical services; accordingly women and family members are often blamed for their poor utilisation of medical services during pregnancy and childbirth (Douglas, 2 1994;Cindoglu and Sayan-Cengiz, 2010;Varley, 2010;Brown et al, 2011;Kooienga and Stewart, 2011;Moore et al, 2011;Coxon et al, 2012). This is particularly so in Nepal (Thapa et al, 2001;Regmi and Madison, 2009;Ahmed et al, 2010;Brunson, 2010;Basnyat, 2011).…”