Changing the place of birth from home to health facilities in Kafa Zone, Ethiopia

Women in rural and semi-urban Kafa Zone, Ethiopia are being encouraged to give birth in health facilities rather than at home. Using an earlier 2007 study as a comparison point, this study explored the role of Health Extension Workers (HEWs) in referring women to health centres for birth. Semi-structured interviews were conducted with 11 HEWs and 6 health workers in May and June 2014. The results show that women prefer birth attendants they know, including HEWs, and not to go to health centres or the hospital except for emergencies. The ambulance service linking rural communities with health facilities works better in some areas than others. To improve maternal health, HEWs need better support at the community level. Inefficiencies in the referral system should be addressed.