Background: Institutional delivery care-seeking behavior is considered a crucial step in preventing maternal and child death. However, the barriers and facilitators related to institutional delivery care-seeking behavior in the study area were not studied very in-depth. Hence, the current study aimed to explore barriers and enablers of institutional delivery care-seeking behavior in Northwest Ethiopia.
Methods: A descriptive phenomenological qualitative inquiry was used. The data was collected by using a piloted interview guide. We collected data using in-depth interviews among women and men; and key informant interviews from the Female health development army and health extension workers in November and December 2019. Framework analysis was utilized for the analysis of the data.
Results: This study found out the potential factors which hinder and facilitate institutional delivery. The barriers to institutional delivery included the belief that pregnancy and childbirth are normal and business of women's, women's preference of home delivery with traditional attendants, family influence, fear of bad behavior of health care workers, and lack of resources. The facilitators were free maternal services (ambulance services and maternity services), having the experience of safe childbirth at health facilities, and women's health development army linkage with health extension workers.
Conclusion: This study provides evidence that low-risk perception of home delivery, socio-cultural influences, service provision modalities, and financial factors were the determinants of institutional delivery service use. Therefore, a stage-matched intervention shall be designed to improve the uptake of institutional delivery service use.
Keywords: Ethiopia; Facilitators to institutional delivery; Gondar; Institutional delivery.
Institutional delivery plays a critical role in the prevention of maternal death and improves newborn health. Although most of maternal health services were free of charge in Ethiopia, institutional delivery is low in the rural Central Gondar zone of Wogera and East Dembiya districts. Low institutional delivery was the major contributors to high maternal deaths in Ethiopia. This low utilization of institutional delivery in the study area could also affect the health status of the newborn.This study was conducted to explore the community perceptions of the socio-cultural and health service factors influencing institutional delivery. Overall, 30 interviews (18 In-depth and 12 Key-informants) were conducted in the selected rural kebeles of Wogera and East Dembiya districts to collect data from women and their husbands for in-depth interview; and key informant interviews from the female health development army and health extension workers.The facilitators of institutional delivery categorized into three themes; namely, free maternal services (ambulance services and maternity services), having the experience of safe childbirth at health facilities, and women’s health development army linkage with health extension workers.The socio-cultural factors impeding institutional delivery categorized into five themes; namely, the belief that pregnancy and childbirth are normal and business of women’s, women’s preference of home delivery with traditional attendants, family influence, fear of bad behavior of health care workers, and lack of resources.Conducting a stage-matched intervention shall be designed to improve the uptake of institutional delivery service use in Wogera and East dembiya districts.
© 2022. The Author(s).