Challenges that Hinder Parturients to Deliver in Health Facilities: A Qualitative Analysis in Two Districts of Indonesia
Abstract: There are many
challenges women face to be able to give birth in health facilities in many
parts of Indonesia. This study explores the roles and observations of
close-to-community maternal health providers and other community members on
potential barriers faced by women to deliver in health facilities in two
districts within The Archipelago. Methods: Employing an explorative qualitative
approach, 110 semi-structured interviews and 7 focus group discussions were
conducted in 8 villages in Southwest Sumba, in the East Nusa Tenggara province,
and in 8 villages in Cianjur, in the West Java province. The participants
included village midwives, Posyandu volunteer (village health volunteers),
traditional birth attendants (TBAs), mothers, men, village heads and district
health officials. Results: The main findings were mostly similar in the two
study areas. However, there were some key differences. Preference for TBA care,
traditional beliefs, a lack of responsiveness of health providers to local
traditions, distance, cost of travel and indirect costs of accompanying family
members were all barriers to patients attending health facilities for the birth
of their child. TBAs were the preferred health providers in most cases due to
their close proximity at the time of childbirth and their adherence to
traditional practices during pregnancy and delivery. Conclusions: Improving
collaborations between midwives and TBAs, collaboration, and responsiveness to
traditional practices within health facilities and effective health promotion
campaigns about the benefits of giving birth in health facilities may increase
the use of health facilities in both study areas.
Keywords: health facilities;
health promotion; midwifery; pregnant women
Author: Sudirman Nasir,
Rukhsana Ahmed, Miladi Kurniasari, Ralalicia Limato, Olivia Tulloch, Din
Syafruddin, Korrie de Koning
Journal Code: jpkedokterangg160330
