Experiences of Homeless Women on Maternal Health Service Utilization and Associated Challenges in Aksum Town, Norther n Ethiopia

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.