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Barriers to using s...
Barriers to using skilled birth attendants' services in mid- and far-western Nepal : a cross-sectional study
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- Choulagai, Bishnu (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Sahlgrenska Academy at University of Gothenburg / Tribhuvan University, Kathmandu, Nepal
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- Onta, Sharad (author)
- Tribhuvan University, Kathmandu, Nepal
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- Subedi, Narayan (author)
- Nepal Public Health Foundation, Kathmandu, Nepal
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- Mehata, Suresh (author)
- Nepal Public Health Foundation, Kathmandu, Nepal
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- Bhandari, Gajananda P (author)
- Nepal Public Health Foundation, Kathmandu, Nepal
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- Poudyal, Amod (author)
- Tribhuvan University, Kathmandu, Nepal
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- Shrestha, Binjwala (author)
- Tribhuvan University, Kathmandu, Nepal
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- Mathai, Matthews (author)
- World Health Organization, Geneva, Switzerland
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- Petzold, Max, 1973 (author)
- Gothenburg University,Göteborgs universitet,Akademistatistik,Centre for Applied Biostatistics,Sahlgrenska Academy at University of Gothenburg
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- Krettek, Alexandra, 1968- (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Institute of Medicine, Sahlgrenska Academy at University of Gothenburg / Nordic School of Public Health NHV Gothenburg
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(creator_code:org_t)
- BioMed Central (BMC), 2013
- 2013
- English.
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In: BMC International Health and Human Rights. - : BioMed Central (BMC). - 1472-698X. ; 13:1
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https://his.diva-por... (primary) (Raw object)
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Abstract
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- BACKGROUND: Skilled birth attendants (SBAs) provide important interventions that improve maternal and neonatal health and reduce maternal and neonatal mortality. However, utilization and coverage of services by SBAs remain poor, especially in rural and remote areas of Nepal. This study examined the characteristics associated with utilization of SBA services in mid- and far-western Nepal.METHODS: This cross-sectional study examined three rural and remote districts of mid- and far-western Nepal (i.e., Kanchanpur, Dailekh and Bajhang), representing three ecological zones (southern plains [Tarai], hill and mountain, respectively) with low utilization of services by SBAs. Enumerators assisted a total of 2,481 women. All respondents had delivered a baby within the past 12 months. We used bivariate and multivariate analyses to assess the association between antenatal and delivery care visits and the women's background characteristics.RESULTS: Fifty-seven percent of study participants had completed at least four antenatal care visits and 48% delivered their babies with the assistance of SBAs. Knowing the danger signs of pregnancy and delivery (e.g., premature labor, prolonged labor, breech delivery, postpartum hemorrhage, severe headache) associated positively with four or more antenatal care visits (OR = 1.71; 95% CI: 1.41-2.07). Living less than 30 min from a health facility associated positively with increased use of both antenatal care (OR = 1.44; 95% CI: 1.18-1.77) and delivery services (OR = 1.25; CI: 1.03-1.52). Four or more antenatal care visits was a determining factor for the utilization of SBAs.CONCLUSIONS: Less than half of the women in our study delivered babies with the aid of SBAs, indicating a need to increase utilization of such services in rural and remote areas of Nepal. Distance from health facilities and inadequate transportation pose major barriers to the utilization of SBAs. Providing women with transportation funds before they go to a facility for delivery and managing transportation options will increase service utilization. Moreover, SBA utilization associates positively with women's knowledge of pregnancy danger signs, wealth quintile, and completed antenatal care visits. Nepal's health system must develop strategies that generate demand for SBAs and also reduce financial, geographic and cultural barriers to such services.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
Keyword
- Antenatal care
- Delivery care
- Utilization
- Skilled birth attendant
- Barrier
- Nepal
- Antenatal care; Delivery care; Utilization; Skilled birth attendant; Barrier; Nepal
Publication and Content Type
- ref (subject category)
- art (subject category)
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Choulagai, Bishn ...
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Onta, Sharad
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Subedi, Narayan
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Mehata, Suresh
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Bhandari, Gajana ...
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Poudyal, Amod
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Shrestha, Binjwa ...
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Mathai, Matthews
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Petzold, Max, 19 ...
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Krettek, Alexand ...
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University of Skövde
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University of Gothenburg