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Factors that hinder or enable maternal health strategies to reduce delays in rural and pastoralist areas in Ethiopia
journal contribution
posted on 2017-02-01, 00:00 authored by Ruth JacksonRuth Jackson, Fisaha TesfayFisaha Tesfay, T G Gebrehiwot, H GodefayOBJECTIVES: 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.
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Journal
Tropical medicine and international healthVolume
22Issue
2Pagination
148 - 160Publisher
WileyLocation
Chichester, Eng.Publisher DOI
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ISSN
1360-2276eISSN
1365-3156Language
engPublication classification
C Journal article; C1 Refereed article in a scholarly journalCopyright notice
2016, WileyUsage metrics
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