Skilled Care at Birth among Rural Women in Nepal: Practice and Challenges

被引:51
|
作者
Dhakal, Sulochana [1 ]
van Teijlingen, Edwin [2 ]
Raja, Edwin Amalraj
Dhakal, Keshar Bahadur [3 ]
机构
[1] Univ Aberdeen, Sect Populat Hlth, Sch Med & Dent, Aberdeen AB25 2ZD, Scotland
[2] Bournemouth Univ, Sch Hlth & Social Care, Bournemouth, Dorset, England
[3] Midwestern Reg Hosp, Birendranagar, Surkhet, Nepal
关键词
Childbirth; Cross-sectional studies; Descriptive studies; Delivery; Rural health services; Skilled attendants; Nepal; HEALTH-CARE; DELIVERY;
D O I
10.3329/jhpn.v29i4.8453
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
In Nepal, most births take place at home, and many, particularly in rural areas, are not attended by a skilled birth attendant. The main objectives of the study were to assess the use of skilled delivery care and barriers to access such care in a rural community and to assess health problems during delivery and seeking care. This cross-sectional study was carried out in two Village Development Committees in Nepal in 2006. In total, 150 women who had a live birth in the 24 months preceding the survey were interviewed using a structured questionnaire. The sample population included married women aged 15-49 years. Forty-six (31%) women delivered their babies at hospital, and 104 (69%) delivered at home. The cost of delivery at hospital was significantly (p<0.001) higher than that of a delivery at home. Results of univariate analysis showed that women from Brahmin-Chhetri ethnicity, women with higher education or who were more skilled, whose husbands had higher education and more skilled jobs, had first or second childbirth, and having adverse previous obstetric history were associated with institutional delivery while women with higher education and having an adverse history of pregnancy outcome predicted the uptake of skilled delivery care in Nepal. The main perceived problems to access skilled delivery care were: distance to hospital, lack of transportation, lack of awareness on delivery care, and cost. The main reasons for seeking intrapartum care were long labour, retained placenta, and excessive bleeding. Only a quarter of women sought care immediately after problems occurred. The main reasons seeking care late were: the woman or her family not perceiving that there was a serious problem, distance to health facility, and lack of transport. The use of skilled birth attendants at delivery among rural women in Nepal is very poor. Home delivery by unskilled birth attendants is still a common practice among them. Many associated factors relating to the use of skilled delivery care that were identified included age, education and occupation of women, and education and occupation of husbands. Therefore, the availability of skilled delivery care services at the community, initiation of a primary health centre with skilled staff for delivery, and increasing awareness among women to seek skilled delivery care are the best solution.
引用
收藏
页码:371 / 378
页数:8
相关论文
共 50 条
  • [1] An exploration of the attitudes and beliefs of rural women towards skilled birth attendants in Nepal
    S Forrest
    [J]. BMC Proceedings, 6 (Suppl 4)
  • [3] Utilisation of postnatal care among rural women in Nepal
    Dhakal S.
    Chapman G.N.
    Simkhada P.P.
    van Teijlingen E.R.
    Stephens J.
    Raja A.E.
    [J]. BMC Pregnancy and Childbirth, 7 (1)
  • [4] Empowerment, intimate partner violence and skilled birth attendance among women in rural Uganda
    Betty Kwagala
    Olivia Nankinga
    Stephen Ojiambo Wandera
    Patricia Ndugga
    Allen Kabagenyi
    [J]. Reproductive Health, 13
  • [5] Empowerment, intimate partner violence and skilled birth attendance among women in rural Uganda
    Kwagala, Betty
    Nankinga, Olivia
    Wandera, Stephen Ojiambo
    Ndugga, Patricia
    Kabagenyi, Allen
    [J]. REPRODUCTIVE HEALTH, 2016, 13
  • [6] Inequality of the Use of Skilled Birth Assistance Among Rural Women in Bangladesh: Facts and Factors
    Kamal, S. M. Mostafa
    Hassan, Che Hashim
    Kabir, M. A.
    [J]. ASIA-PACIFIC JOURNAL OF PUBLIC HEALTH, 2015, 27 (02) : NP1321 - NP1332
  • [7] Safe delivery care practices in western Nepal: Does women's autonomy influence the utilization of skilled care at birth?
    Bhandari, Tulsi Ram
    Kutty, V. Raman
    Sarma, P. Sankara
    Dangal, Ganesh
    [J]. PLOS ONE, 2017, 12 (08):
  • [8] Birth preparedness and complication readiness among women and couples and its association with skilled birth attendance in rural Bangladesh
    Islam, Sajia
    Perkins, Janet
    Siddique, Md. Abu Bakkar
    Mazumder, Tapas
    Haider, Mohammad Rifat
    Rahman, Mohammad Masudur
    Capello, Cecilia
    Hoque, Dewan Md. Emdadul
    Santarelli, Carlo
    El Arlfeen, Shams
    Rahman, Ahmed Ehsanur
    [J]. PLOS ONE, 2018, 13 (06):
  • [9] Training skilled birth attendants in Nepal
    不详
    [J]. REPRODUCTIVE HEALTH MATTERS, 2005, 13 (26) : 194 - 194
  • [10] No time, no money, no luck: Barriers to prenatal care among dalit women in rural Nepal
    Gautam, Dipa Sharma
    Hearn, Gesine
    [J]. HEALTH CARE FOR WOMEN INTERNATIONAL, 2019, 40 (7-9) : 914 - 930