Factors influencing non-utilisation of maternity care services in Sagamu, South Western Nigeria
AbstractObjective: To determine the factors influencing the utilization of maternity care in the public health facilities in the Sagamu Community.
Materials and Methods: With the aid of pre-tested structured interview questionnaires, a comparative cross-sectional study was conducted in Sagamu among expectant mothers patronizing the traditional birth attendants (TBAs) and the public maternity centres, so as to determine the factors responsible for the non-utilization of skilled maternity care and the utilization of health services by the expectant mothers in Sagamu community in September 2002. The process indicator of skilled care at delivery (i.e. percentage of births assisted by skilled attendants) is the United Nations General Assembly recommendation (1999) being used as a benchmark indicator to measure progress towards reducing maternal mortality.
Results: Religion, cost of services and distance to the health facilities were found not to be contributory to the non-utilization of health facilities. Rather, socio-cultural beliefs in the TBA services, low educational status, and husband and family decision (gender influence) were found to be strong determinants of the non-utilization of the maternity centres by expectant mothers in this community. Improving the educational status of women, reducing the waiting time at hospitals, improving the quality of care and raising women's status so that they are empowered to make critical health decisions will enhance the use of skilled maternity care and utilization of health facilities by expectant mothers.
Conclusion: It is recommended that qualitative research should be conducted in every community to identify traditional beliefs, customs and taboos that may be a deterrent to utilization of skilled maternity care. The information obtained should be used to develop a health communication plan for the community on maternal care.
Keywords: maternal mortality, maternity services, traditional birth attendants (TBA)
Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 48-53
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