Mekdes Gurara1, Kristel Muyldermans2, Yves Jacquemyn3, Jean-Pierre Van Geertruyden4, Veerle Draulans5. 1. Department of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia; Arba Minch Health and Demographic Surveillance Site, Arba Minch University, Arba Minch, Ethiopia. Electronic address: mekdes.kondale@amu.edu.et. 2. Department of Obstetrics and Gynaecology, H. Hartziekenhuis, Mol, Belgium. 3. Department of Obstetrics and Gynaecology, UZA Antwerp University Hospital, Wilrijkstraat10, 2650, Edegem, Belgium; Global Health Institute, Faculty of Medicine & Health Sciences, University of Antwerp, Doornstraat 331, BE-2610, Wilrijk, Belgium. 4. Global Health Institute, Faculty of Medicine & Health Sciences, University of Antwerp, Doornstraat 331, BE-2610, Wilrijk, Belgium. 5. Faculty of Social Sciences, Centre for Sociological Research, Katholieke University Leuven, Parkstraat 45, B-3000 Leuven, Belgium.
Abstract
BACKGROUND: In Ethiopia, it is encouraged that labour and delivery care are performed under the observation of skilled/trained midwifery or medical professionals. However, 70% of all births occur outside the healthcare system under the care of unskilled birth attendants, family members, or without any assistance at all. OBJECTIVE: This study aimed to assess the reasons for choosing homebirth and the role of traditional birth attendants in Arba Minch Health and Demographic Surveillance Site. METHOD: A qualitative, exploratory study was carried out between May and June 2017. Twenty-nine semi-structured interviews were conducted with various respondent groups such as traditional birth attendants, pregnant women, skilled birth attendants, and health extension workers. Data were transcribed and for analysis, structured as per the participants' responses, sorted and categorized as per the topic guide, and presented in narrative form. FINDINGS: The study revealed that traditional birth attendants are actively engaged in assisting homebirths in the selected area. It was also found that many women still prefer traditional birth attendants for childbirth assistance. Reasons for choosing homebirth included lack of transport to health care facilities, distance to health care facilities, lack of respectful care at health care facilities, and the friendliness of traditional birth attendants. Lack of formal partnerships between traditional birth attendants and the health system was also observed. CONCLUSIONS: There is a need to incorporate traditional birth attendants as a link between healthcare facilities and pregnant women; thereby, improving respectful care at the healthcare facilities.
BACKGROUND: In Ethiopia, it is encouraged that labour and delivery care are performed under the observation of skilled/trained midwifery or medical professionals. However, 70% of all births occur outside the healthcare system under the care of unskilled birth attendants, family members, or without any assistance at all. OBJECTIVE: This study aimed to assess the reasons for choosing homebirth and the role of traditional birth attendants in Arba Minch Health and Demographic Surveillance Site. METHOD: A qualitative, exploratory study was carried out between May and June 2017. Twenty-nine semi-structured interviews were conducted with various respondent groups such as traditional birth attendants, pregnant women, skilled birth attendants, and health extension workers. Data were transcribed and for analysis, structured as per the participants' responses, sorted and categorized as per the topic guide, and presented in narrative form. FINDINGS: The study revealed that traditional birth attendants are actively engaged in assisting homebirths in the selected area. It was also found that many women still prefer traditional birth attendants for childbirth assistance. Reasons for choosing homebirth included lack of transport to health care facilities, distance to health care facilities, lack of respectful care at health care facilities, and the friendliness of traditional birth attendants. Lack of formal partnerships between traditional birth attendants and the health system was also observed. CONCLUSIONS: There is a need to incorporate traditional birth attendants as a link between healthcare facilities and pregnant women; thereby, improving respectful care at the healthcare facilities.