Reasons rural Laotians choose home deliveries over delivery at health facilities a qualitative study 英文参考文献.docVIP

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Reasons rural Laotians choose home deliveries over delivery at health facilities a qualitative study 英文参考文献.doc

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Reasons rural Laotians choose home deliveries over delivery at health facilities a qualitative study 英文参考文献

Sychareunetal.BMCPregnancyandChildbirth2012,12:86 /1471-2393/12/86 RESEARCH ARTICLE OpenAccess ReasonsruralLaotianschoosehomedeliveries overdeliveryathealthfacilities:aqualitative study VanphanomSychareun1,3*,VisanouHansana1,VatsanaSomphet1,SisouvanhXayavong1, AlongkonePhengsavanh1andRebeccaPopenoe2 Abstract Background:MaternalmortalityamongpoorruralwomenintheLaoPeople’sDemocraticRepublic(LaoPDR)is amongthehighestinSoutheastAsia,inpartbecauseonly15%givebirthathealthfacilities.Thisstudyexplored whywomenandtheirfamiliespreferhomedeliveriestodeliveriesathealthfacilities. Methods:AqualitativestudywasconductedfromDecember2008toFebruary2009intwoprovincesofLaoPDR. Datawascollectedthrougheightfocusgroupdiscussions(FGD)aswellasthroughin-depthinterviewswith12 motherswhodeliveredathomeduringthelastyear,eighthusbandsandeightgrandmothers,involvingatotalof 71respondents.ContentanalysiswasusedtoanalyzetheFGDandinterviewtranscripts. Results:Obstaclestogivingbirthathealthfacilitiesincluded:(1)Distancetothehealthfacilitiesanddifficultiesand costsofgettingthere;(2)Attitudes,qualityofcare,andcarepracticesatthehealthfacilities,includingahorizontal birthposition,episiotomies,lackofprivacy,andthepresenceofmalestaff;(3)Thewishtohavefamilymembers nearbyandtheneedforwomentobeclosetotheirotherchildrenandthehousework;and(4)Thewishtofollow traditionalbirthpracticessuchasgivingbirthinasquattingpositionandlyingona“hotbed”afterdelivery.The decisionaboutwheretogivebirthwascommonlymadebythewoman’shusband,mother,mother-in-laworother relativesinconsultationwiththewomanherself. Conclusion:ThisstudysuggeststhatthepreferenceinruralLaosforgivingbirthathomeisduetoconvenience, cost,comfortandtradition.InordertoassuresaferbirthsandreduceruralLaoPDR’shighmaternalmortalityrate, healthcenterscouldconsideraccommodatingthewishesandtraditionalpracticesofmanyruralLaotians:allowing familyinthebirthingrooms;allowingtraditionalpractices;andimprovingattitudesamongstaff.Traditionalbirth attendants,women,andtheirfamil