TY - JOUR
T1 - Health care seeking behaviours in pregnancy in rural Sindh, Pakistan
T2 - A qualitative study
AU - Qureshi, Rahat Najam
AU - Sheikh, Sana
AU - Khowaja, Asif Raza
AU - Hoodbhoy, Zahra
AU - Zaidi, Shujaat
AU - Sawchuck, Diane
AU - Vidler, Marianne
AU - Bhutta, Zulfiqar A.
AU - Von Dadeslzen, Peter
N1 - Publisher Copyright:
© 2016 Qureshi et al.
PY - 2016/6/8
Y1 - 2016/6/8
N2 - Background: Pakistan has alarmingly high numbers of maternal mortality along with suboptimal care-seeking behaviour. It is essential to identify the barriers and facilitators that women and families encounter, when deciding to seek maternal care services. This study aimed to understand health-seeking patterns of pregnant women in rural Sindh, Pakistan. Methods: A qualitative study was undertaken in rural Sindh, Pakistan as part of a large multi-country study in 2012. Thirty three focus group discussions and 26 in-depth interviews were conducted with mothers [n = 173], male decision-makers [n = 64], Lady Health Workers [n = 64], Lady Health Supervisors [n = 10], Women Medical Officers [n = 9] and Traditional Birth Attendants [n = 7] in the study communities. A set of a priori themes regarding care-seeking during pregnancy and its complications as well as additional themes as they emerged from the data were used for analysis. Qualitative analysis was done using NVivo version 10. Results: Women stated they usually visited health facilities if they experienced pregnancy complications or danger signs, such as heavy bleeding or headache. Findings revealed the importance of husbands and mothers-in-law as decision makers regarding health care utilization. Participants expressed that poor availability of transport, financial constraints and the unavailability of chaperones were important barriers to seeking care. In addition, private facilities were often preferred due to the perceived superior quality of services. Conclusion: Maternal care utilization was influenced by social, economic and cultural factors in rural Pakistani communities. The perceived poor quality care at public hospitals was a significant barrier for many women in accessing health services. If maternal lives are to be saved, policy makers need to develop processes to overcome these barriers and ensure easily accessible high-quality care for women in rural communities.
AB - Background: Pakistan has alarmingly high numbers of maternal mortality along with suboptimal care-seeking behaviour. It is essential to identify the barriers and facilitators that women and families encounter, when deciding to seek maternal care services. This study aimed to understand health-seeking patterns of pregnant women in rural Sindh, Pakistan. Methods: A qualitative study was undertaken in rural Sindh, Pakistan as part of a large multi-country study in 2012. Thirty three focus group discussions and 26 in-depth interviews were conducted with mothers [n = 173], male decision-makers [n = 64], Lady Health Workers [n = 64], Lady Health Supervisors [n = 10], Women Medical Officers [n = 9] and Traditional Birth Attendants [n = 7] in the study communities. A set of a priori themes regarding care-seeking during pregnancy and its complications as well as additional themes as they emerged from the data were used for analysis. Qualitative analysis was done using NVivo version 10. Results: Women stated they usually visited health facilities if they experienced pregnancy complications or danger signs, such as heavy bleeding or headache. Findings revealed the importance of husbands and mothers-in-law as decision makers regarding health care utilization. Participants expressed that poor availability of transport, financial constraints and the unavailability of chaperones were important barriers to seeking care. In addition, private facilities were often preferred due to the perceived superior quality of services. Conclusion: Maternal care utilization was influenced by social, economic and cultural factors in rural Pakistani communities. The perceived poor quality care at public hospitals was a significant barrier for many women in accessing health services. If maternal lives are to be saved, policy makers need to develop processes to overcome these barriers and ensure easily accessible high-quality care for women in rural communities.
KW - Antenatal care
KW - Associated factors
KW - Health facilities
KW - Health seeking behaviour
KW - Pakistan
KW - Patient acceptance of health care
KW - Pregnancy
KW - Pregnancy complications
UR - http://www.scopus.com/inward/record.url?scp=84973517463&partnerID=8YFLogxK
U2 - 10.1186/s12978-016-0140-1
DO - 10.1186/s12978-016-0140-1
M3 - Article
C2 - 27356863
AN - SCOPUS:84973517463
SN - 1742-4755
VL - 13
JO - Reproductive Health
JF - Reproductive Health
IS - 1
M1 - 13
ER -
