Maternal morbidity in rural upper Egypt: levels, determinants, and care seeking

Although maternal morbidity constitutes a serious public health problem in Egypt, it has remained a neglected area for public health research. In this study we used a synthetic design combining quantitative and qualitative methods to determine the level of maternal morbidity as reported by mothers in rural Upper Egypt and to identify patterns and determinants of care seeking for perceived morbidity in pregnancy, childbirth, and the postpartum period. The reported incidence of danger symptoms indicated that maternal morbidity is a serious problem in Egypt and, therefore, warranted community-based interventions. The study suggested a model explaining the criteria women used to judge whether and from where they would seek care. The model incorporates three cognitive components related to the perceived frequency, and seriousness of the problem and the degree of personal responsibility for the problem. Utilization of care was shown to be low and significantly associated with poverty and husband illiteracy. Likewise, most deliveries were not attended by a trained health care workers, and these unattended deliveries were shown to be associated with nonutilization of antenatal care, illiteracy, nonownership of cattle, and inaccessibility to potable water.