Abstract
In Ethiopia, delivery wards are a part of primary healthcare services. However, although the maternal mortality rate is very high, approximately 50% of mothers use skilled birth attendants. This study focused on how women in a rural southern district of Ethiopia experience maternity care offered at the local delivery wards. In this qualitative, exploratory study, 19 women who had given birth in a healthcare facility were interviewed in 2019. Individual in-depth interviews were supplemented with observations conducted at 2 different delivery wards in the same district in 2020. Two main themes emerged from the thematic content analysis: increased awareness and safety were the primary reasons for giving birth at a healthcare facility, and traditions and norms affected women’s birth experiences in public maternity wards. The main shortcomings were a shortage of medicine, ambulance not arriving in time, and lack of care at night. For some women, being assisted by a male midwife could be challenging, and the inability to afford necessary medicine made adequate treatment inaccessible. Providing continuous information gave the women a certain feeling of control. Strong family involvement indicated that collectivistic expectations were key to rural delivery wards. The healthcare system must be structured to meet women’s needs. Moreover, managers and midwives should ensure that birthing women receive high-quality, safe, timely, and respectful care.
Highlights
Primary healthcare facilities are important elements of the current Ethiopian maternity care system, which has undergone significant structural changes in recent years.[1]
The majority of the women said they were happy with the maternity care they received and used safe childbirth as the key term to describe why they preferred skilled birth attendants
When asked what extra value they received from giving birth at a healthcare facility, most women pointed to the professional treatment, especially in case of birth-related complications
Summary
Primary healthcare facilities are important elements of the current Ethiopian maternity care system, which has undergone significant structural changes in recent years.[1]. The aim is to improve pregnant women’s health and to teach them about the benefits of facility-based childbirth. Health extension workers (HEWs) are prepared to strengthen the utilization of facility-based childbirth. These are local women who prepare groups of pregnant women and are trained to conduct preventive healthcare and individual follow-up before childbirth in the local community as a part of ANC. The HEWs inform pregnant women about the benefits of giving birth in a maternity ward and contribute to the implementation of the authorities’ goal that all women should give birth in healthcare facilities and not at home anymore.[4]
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