Challenges of Maternal Health Services Utilizations and Provisions from Health Posts in Bale Zone, Oromiya Regional State, Southeast Ethiopia: Qualitative Study

Abstract

Background: More than 80% of maternal deaths can prevented if pregnant women access to essential maternity care like antenatal care, institutional delivery and postnatal care. To reduce maternal mortality, Ethiopian government trained Health Extension Workers who working at grass root level. Even though, Health Extension Workers trained and assigned to health posts, the challenges they faced on provision of maternal health services was not investigated. Therefore, this study was to explore challenges of maternal health services utilization and provision from health posts in Bale Zone, Oromiya Region, Southeast Ethiopia. Methods: Explorative qualitative design was conducted. Women less than one-year child and married men were participated in focus group discussions. While health extensions workers and supervisors, women’s affairs, religious leaders, district and zonal health extension programs coordinators were participated in in-depth interviews. Five focus group discussions and thirty-one in-depth interviews conducted. Data collected by tape recording and note taking using semi- structured guiding questionnaires from April 15-May 15 in 2014. Randomly five districts selected from zone and one Sub - district selected purposively from each district. The results analyzed by thematic coding analysis and presented in a narrative form. Results: Participants claimed that community was not comfortable with Health Extension Workers. Most of Health Extension Workers complained for shortage of equipments, electric powers and water supplies. Some Health Extension Workers left jobs totally due to un-equivalent salary with their workload and some left their jobs for several months by closing health posts. There was also communication gap between district health office and health center on supervisions. Conclusions: Even though, Antenatal care services utilization from Health Extension Workers was good, the delivery and postnatal care services utilization were not as such. In general, the attitudes of the communities toward health extension workers, shortage of equipments, shortage of water supply, lack of electric power, Health Extension Workers left the jobs totally, Health Extension Workers left the jobs for several months and movement of communities from one place to another place were the major challenges of maternal health services utilizations from health posts. The Oromiya Health Bureau, Bale Zone Health Department and District Health Office should have to work cooperatively to avail necessary equipments and infrastructures for health posts, to reconsider salary of health extension workers, to train additional health extension workers for better maternal health services utilizations and provisions.