high anc coverage and low skilled attendance in a rural tanzanian district a case for implementing a birth plan intervention高anc覆盖和低熟练出席在坦桑尼亚的农村地区情况下实现生产计划的干预.pdfVIP

Magoma et al. BMC Pregnancy and Childbirth 2010, 10:13 /1471-2393/10/13 RESEARCH ARTICLE Open Access High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention 1* 2 1 1 1 Moke Magoma , Jennifer Requejo , Oona MR Campbell , Simon Cousens , Veronique Filippi Abstract Background: In Tanzania, more than 90% of all pregnant women attend antenatal care at least once and approximately 62% four times or more, yet less than five in ten receive skilled delivery care at available health units. We conducted a qualitative study in Ngorongoro district, Northern Tanzania, in order to gain an understanding of the health systems and socio-cultural factors underlying this divergent pattern of high use of antenatal services and low use of skilled delivery care. Specifically, the study examined beliefs and behaviors related to antenatal, labor, delivery and postnatal care among the Maasai and Watemi ethnic groups. The perspectives of health care providers and traditional birth attendants on childbirth and the factors determining where women deliver were also investigated. Methods: Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed. Results: The Maasai and Watemi women’s preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all wom