"You just endure": Maternal and Child Healthcare Utilization in Iganga, Uganda Open Access

Kozlowski, Debra (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/zg64tm149?locale=en
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Abstract

Background: High maternal mortality ratios and under-5 mortality rates plague Uganda. The use of maternal and child healthcare services is very low in the nation's rural Eastern district of Iganga. Research in the community is used to create evidence based interventions that may increase utilization of services within the region.

Objectives: The study aimed to identify obstacles to accessing maternal and child healthcare, motivations for seeking out this care, and attitudes towards the health care facilities in the Iganga region. The study captured individual community members' points of view to assist stakeholders in planning to improve access to and quality of local maternal and child care.

Methods: The study utilized qualitative in-depth exit interviews to question participants on their experiences with the care provided during recent antenatal visits, deliveries, and child health visits to understand how and why they have received maternal or child care. The twenty-two interviews completed at four health facilities in Iganga aimed to capture participants' motivations, beliefs, and personal stories of maternal and child healthcare. Data from the interviews were conceptualized through deep descriptions and comparisons for analysis.

Results: The path of maternal and child healthcare utilization includes many factors that either encourage or impede the eventual successful receipt of care. Ideally, an individual would move from pregnancy to antenatal care to delivery care and child care uninterrupted. However, complications arise as first, second, or third delays along this path. This study revealed a pattern of behaviors in which individuals were influenced before attempting to receive care by encouragement or discouragement from husbands, mothers-in law, and community members.Individuals that successfully utilized maternal and child health services had two things in common: a belief that a visit to a health facility would be beneficial and an ability to persevere.

Discussion: Endurance is the key factor that can lead individuals to overcome obstacles related to the Three Delays and find the care they need. Encouragement from friends and family, pregnancy and birth planning, financial saving, and a positive perception of the health care facilities contribute to the successful utilization of maternal and child care in Iganga.

Table of Contents

Table of Contents

Glossary of terms 1

Introduction 2

Healthcare Services Utilization and Maternal and Child Mortality in Iganga, Uganda 2

Map 1. District Map of Uganda 5

Problem Statement 7

Purpose Statement 8

Research Question 8

Significance Statement 8

Literature Review 9

Understanding Maternal and Child Healthcare Service Utilization in Iganga, Uganda through the Three Delays Model 9

The Problem of Inadequate Maternal and Child Care 11

Barriers to Maternal and Child Care in East Africa 13

Methodology 17

Research Design 17

Population and Sample 17

Figure 1. Participant Characteristics 18

Study Aims 18

Procedures 19

Instruments 20

Data Analysis 21

Ethical Considerations 22

Limitations 22

Results 23

Navigating maternal and child healthcare services 23

Figure 2. Process of Maternal and Child Healthcare Utilization in Iganga, Uganda 24

Overcoming the barriers to care 30

Observations and additional findings 32

Summary of findings 33

Discussion 35

Recommendations 38

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