Abstract
BackgroundIn fragile and war-affected setting such as South Sudan, a combination of physical environmental, socioeconomic factors and healthcare’s characteristic contributes to higher rates of home delivery attended by unskilled attendants. This study aims to understand the community members’ experience, perceptions and the barriers in relation to accessing and utilizing maternal healthcare services in South Sudan.MethodsWe conducted in-depth one-on-one interview with 30 women and 15 men to investigate their perspectives on the barriers to access maternal and child health related services. We purposively selected women and their partners in this study.ResultsOur study revealed that inadequate quality of antenatal care services such as lack of essential medicine, supplies and tools was linked to individual’s mothers dissatisfaction with the services they received. In addition, sudden onset of labor and lack of safety and security were important reasons for home delivery in this study. Furthermore, lack of transport as a result of a combination of long distance to a facility and associated costs either restricted or delayed women reaching the health facilities.ConclusionsOur study highlighted an urgent need for the government of South Sudan to implement security and safety measures in order to improved access to delivery service at night. Incorporating private transports to provide access to affordable and reliable transport services for pregnant and post-partum women is also important. Increasing the budget allocation for medicine and health supplies and improving management of medicine and supply chain logistics are essential.
Highlights
In fragile and war-affected setting such as South Sudan, a combination of physical environmental, socioeconomic factors and healthcare’s characteristic contributes to higher rates of home delivery attended by unskilled attendants
During the millennium development goals era the proportion of deliveries attended by a skilled attendant increased from 59 to 71% from 1990 to 2015 [2]
The wider study aimed to explore the perceived and experienced barriers faced by the community members to access healthcare services, as well as the barriers faced by the healthcare providers to deliver healthcare services to their client
Summary
In fragile and war-affected setting such as South Sudan, a combination of physical environmental, socioeconomic factors and healthcare’s characteristic contributes to higher rates of home delivery attended by unskilled attendants. The reduction of the maternal mortality ratio to less than 70 per 100,000 live births between 2016 and 2030 is one of the global priority targets of the Sustainable Development Goals [1]. Mugo et al BMC Health Services Research (2018) 18:10 the developing countries with the highest maternal mortality rate and it was estimated at 789 per 100,000 live birth [9]. A combination of physical environment, social and economic factors, and the individual woman’s characteristics and behaviors increases the lifetime risk of maternal mortality among women of reproductive age and among their under-five children. According to 2010 South Sudan household survey report the neonatal mortality rate was estimated at 40 per 1000 live birth, an infant mortality rate of 74 per 1000 live birth and under-five mortality rates of 101 per 1000 live birth [12, 13]
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