Abstract:
Background: Beyond the lack of safe and suitable home, homeless women are at high risk of
poor health outcomes. They are vulnerable group for different risk factors including risks of
pregnancy and childbirth related complications. They may also face multiple challenges to
access and utilize maternal health services.Therefore,the aim of this study was to explore
experience of homeless women on maternal health service utilization and associated
challenges in Aksum Town,Northern Ethiopia.
Methods: A phenomenological study design was conducted from February to March 2016.
In-depth interviews were conducted with purposively selected 12 homeless women and five
key informants. Data were captured using audio recorders and field notes; transcribed
verbatim and translated from local language into English then thematic analysis approach was
implemented supported by Atlas ti-7.1 software. Triangulation, thick description, reflexivity
and bracketing were applied to assure quality of the finding.
Results: The finding of this study reveals that most homeless women do not use any of the
basic maternal health services,namely antenatal care; skilled birth attendance and postnatal
care for their recent pregnancy, childbirth and post-delivery. Lack of fixed home, lack of
information about the importance of maternal health service and obstetric complications;
religious and traditional believes; lack of social support and decision making power; lack of
previous contact with health system, financial constraints were important reasons hindering
homeless women access and use of maternal health service.
Conclusions: Even though maternal health service utilization is the most crucial intervention
to reduce maternal and newborn deaths, this finding shows that maternal health service
utilization among homeless women was very limited and several factors contributed to nonuse of these services including financial, socio-cultural and health care facility relaed
challenges were the reasons for low maternal health service utilization. This call for
concerned and collaborated efforts to address the underlying challenges being faced by
homeless women to improve maternal health service utilization.
