Abstract
ABSTRACTObjective:women are more likely to give birth at a health facility when their families agree with the birthplace. However, in rural areas of Tanzania, women are often marginalized from decision-making. This study predicted birthplace intention and identified factors to reduce perceptional gaps among pregnant women, husbands and family members. Method:explanatory cross-sectional survey was conducted in three villages in North Eastern Tanzania. Participants were 138 pregnant women and their families who answered the Birth Intention Questionnaire (BIQ), measuring knowledge, attitude, perceived behavioral control, subjective norms and intention for birthplace. Descriptive analysis, ANOVA, Chi-square, and multiple linear regression was used to analyze the data. Results:the regression model showed that knowledge, perceived behavioral control, and subjective norms predicted intention for birthplace (R2 = .28). While 81% of pregnant women thought their husbands were decision-makers for their birth, only 38% of husbands and 37% of family members agreed. Pregnant women had significantly lower scores on the item “I will prepare for childbirth with my family” compared with husbands (p < .01) and other family members (p < .001). Conclusion:providing evidence-based birth preparation and reducing the identified perceptual gaps may enhance women’s intention to deliver at health facilities.
Highlights
People-centered care is one of the key health policies of the World Health Organization to achieve Universal Health Coverage[1]
We developed nine items to tap into the concept of perceived behavioral control (PBC), which refers to the perceived ease or difficulty of performing the behavior and it is assumed to reflect past experience as well as anticipated impediments and obstacles[15]
While only 32.5% of pregnant women agreed, 61.8% of husbands and 81.4% of family members agreed resulting in significant differences between pregnant women and husbands (p < 0.001) as well as between pregnant women and family members (p < 0.01). In this survey of pregnant women, husbands, and family members occurring in the rural mountainous villages in Korogwe District, the regression model www.eerp.usp.br/rlae identified that Knowledge and PBC predicted Intention
Summary
People-centered care is one of the key health policies of the World Health Organization to achieve Universal Health Coverage[1]. More research on women’s voices needs to be conducted so that health care service meets their needs[2]. A case in point is that in rural Tanzania, skilled birth attendants (SBAs) conducted only 42.3% of all deliveries[3] access to SBAs in health care facilities is strongly recommended[4]. The maternal mortality ratio (MMR) per 100,000 live births of Tanzania was 410 in 2013(5). This stalled the progress of Millennium Development Goal 5. Much effort is needed to achieve the Sustainable Development Goal 3: reducing MMR to 70
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