Free Content Waiting too long: low use of maternal health services in Kalabo, Zambia

Authors: Stekelenburg J.; Kyanamina S.1; Mukelabai M.; Wolffers I.2; Roosmalen J.3

Source: Tropical Medicine & International Health, Volume 9, Number 3, March 2004 , pp. 390-398(9)

Publisher: Blackwell Publishing

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Abstract:

Summary Objective

To determine the level of use of maternal health services and to identify and assess factors that influence women's choices where to deliver in Kalabo District, Zambia. Methods

A cross-sectional descriptive study conducted between 1998 and 2000, with 332 women interviewed using semi-structured questionnaires. Focus group discussions were held and hospital data and registers were checked. Results

Although 96% of respondents would prefer to deliver in a clinic, only 54% actually did, because of long distances, lack of transport, user fees, lack of adequate health education given during antenatal clinic attendances, poorly staffed and ill-equipped institutions with poorly skilled personnel. Conclusion

Unmarried women, women with higher education and women with formal employment, who are able to pay the user fees and live near a clinic are more likely to deliver in a clinic. This does not guarantee survival, however; maternal mortality is high in the district; health facilities are poorly staffed, poorly skilled and ill-equipped.

Keywords: use; maternity care; maternal mortality; maternity waiting home

Document Type: Research article

DOI: 10.1111/j.1365-3156.2004.01202.x

Affiliations: 1: Kalabo District Health Board, Kalabo, Zambia 2: Section Health Care and Culture, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands 3: Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands

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