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Published on: January 12, 2018
Barriers to formal emergency obstetric care services' utilization
Hildah Essendi1, Samuel Mills, Jean-Christophe Fotso
1Centre for Global Health, Population, Poverty and Policy, Faculty of Social and Human Sciences, University of Southampton, Southampton, United Kingdom. H.Essendi@soton.ac.uk
Summary
Urban poor women in Kenya face significant barriers to accessing formal obstetric care, leading many to rely on unskilled traditional birth attendants. Addressing these challenges requires multi-level interventions to reduce maternal mortality.
Area of Science:
- Public Health
- Maternal Health
- Health Services Research
Background:
- Limited access to skilled birth attendance and emergency obstetric care in sub-Saharan Africa contributes to high maternal mortality.
- Women in urban slums face unique challenges in accessing formal healthcare services.
Purpose of the Study:
- To investigate barriers to formal obstetric service utilization among women in Nairobi slums.
- To understand the factors influencing the choice between formal and informal obstetric care.
Main Methods:
- Qualitative study utilizing data from residents of two slums in Nairobi, Kenya, collected in 2006.
- Exploration of community and individual perspectives on healthcare access.
Main Results:
- Slum dwellers express a preference for formal obstetric services but face constraints.
- Barriers include ineffective family health decision-making, inadequate transportation, nighttime insecurity, high costs, and poor quality of formal services.
- Many women resort to traditional birth attendants (TBAs) due to these barriers, increasing risks.
Conclusions:
- Urban poor women encounter multi-level barriers (family, community, facility) to formal obstetric care.
- Interventions must address these systemic issues to reduce maternal morbidity and mortality.
- Recommendations include community education, improved TBA services, enhanced facility quality, and increased security.
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