Abstract
Sudan has high maternal mortality. The rate among nomads - groups of people who move from place to place as a way of obtaining food, finding pasture or make a living - is very high and varies between different regions of the country. The objective of the study is to identify the factors affecting the utilization of maternal health care services by nomadic communities in Sudan, to make recommendations to improve their health. Nomadic health practices and health care services are the main influencing factors affecting the utilization of maternal health care services. Nomadic health practices are influenced by the mobile lifestyle of nomads, their low level of education and knowledge, gender norms, beliefs, values and attitudes, and their geographical locations. Existing health care services are ill-adapted to the nomadic lifestyle. The study also demonstrates some best practices from other countries that can be applied to the nomadic context in Sudan, such as community health workers, training and support for traditional birth attendants, provision of joint mobile health services for humans and livestock and the establishment of maternity or birth waiting homes. Since the utilization of maternal health care services by nomads is extremely low, the study recommends evidence-based strategies to increase community demand for services or bring women closer to emergency obstetric services.
Highlights
Nomads are groups of people who move from place to place as a way of obtaining food, finding pasture for livestock or otherwise make a living (Ahmed and Abdel-Rahman 2008)
There is a need to better understand the factors that influence the status of nomadic maternal health; this study focuses on maternal health among the nomadic communities of Sudan
The highest values of maternal mortality ratio (MMR) are reported in the western part of the country (Darfur and Kordofan) (Ahmed and Abdel-Rahman 2008)
Summary
Nomads are groups of people who move from place to place as a way of obtaining food, finding pasture for livestock or otherwise make a living (Ahmed and Abdel-Rahman 2008). Most nomadic groups follow a fixed annual or seasonal pattern of movement and settlement. They often travel by animal or on foot, and they live in tents or portable shelters made out of tree branches or animal hides. The current estimated number of nomads is uncertain because accurate statistical data are not available. This is probably caused by unclear definitions and vague boundaries between settled and mobile communities (Sheikh and Velema 1999). The majority of nomads (60 %) are found in Africa, where they face numerous challenges in accessing health care services compared to settled populations (Sheikh and Velema 1999; Maro et al 2012)
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