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Factors that hinder or enable maternal health strategies to reduce delays in rural and pastoralist areas in Ethiopia

Jackson, Ruth, Tesfay, Fisaha Haile, Gebrehiwot, Tesfay Gebregzabher and Godefay, Hagos 2017, Factors that hinder or enable maternal health strategies to reduce delays in rural and pastoralist areas in Ethiopia, Tropical medicine and international health, vol. 22, no. 2, pp. 148-160, doi: 10.1111/tmi.12818.

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Title Factors that hinder or enable maternal health strategies to reduce delays in rural and pastoralist areas in Ethiopia
Author(s) Jackson, Ruth
Tesfay, Fisaha Haile
Gebrehiwot, Tesfay Gebregzabher
Godefay, Hagos
Journal name Tropical medicine and international health
Volume number 22
Issue number 2
Start page 148
End page 160
Total pages 13
Publisher Wiley
Place of publication Chichester, Eng.
Publication date 2017-02-01
ISSN 1360-2276
1365-3156
Keyword(s) Ethiopia
Health Extension Workers
maternal health services
three-delays model
referral
skilled birth attendance
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Tropical Medicine
NORTHERN ETHIOPIA
OBSTETRIC CARE
MORTALITY
DELIVERY
COUNTRIES
INTERVENTIONS
CHILDBIRTH
Summary OBJECTIVES: To document factors that hinder or enable strategies to reduce the first and second delays of the Three Delays in rural and pastoralist areas in Ethiopia.

METHODS: A key informant study was conducted with 44 Health Extension Workers in Afar Region, Kafa Zone (Southern Nation, Nationalities and Peoples' Region), and Adwa Woreda (Tigray Region). Health Extension Workers were trained to interview women and ask for stories about their recent experiences of birth. We interviewed the Health Extension Workers about their experiences referring women for Skilled Birth Attendance and Emergency Obstetric and Newborn Care. Data were analysed using thematic analysis.

RESULTS: Themes related to reducing the first delay, such as the tradition of home birth, decision making, distance and unavailability of transport, did not differ between the three locations. Themes related to reducing the second delay differed substantially. Health Extension Workers in Adwa Woreda were more likely to call ambulances due to support from the Health Development Army and a functioning referral system. In Kafa Zone, some Health Extension Workers were discouraged from calling ambulances as they were used for other purposes. In Afar Region, few Health Extension Workers were called to assist women as most women give birth at home with Traditional Birth Attendants unless they need to travel to health facilities for Emergency Obstetric and Newborn Care.

CONCLUSIONS: Initiatives to reduce delays can improve access to maternal health services, especially when Health Extension Workers are supported by the Health Development Army and a functioning referral system, but district (woreda) health offices should ensure that ambulances are used as intended.
Language eng
DOI 10.1111/tmi.12818
Field of Research 111799 Public Health and Health Services not elsewhere classified
160305 Population Trends and Policies
160101 Anthropology of Development
1117 Public Health And Health Services
Socio Economic Objective 920507 Women's Health
HERDC Research category C1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Grant ID Australian Development Awards Scheme (ADRAS) [AusAID Agreement 66420]
Copyright notice ©2016, Wiley
Persistent URL http://hdl.handle.net/10536/DRO/DU:30093172

Document type: Journal Article
Collection: Alfred Deakin Research Institute
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