Exploring the barriers and facilitators to institutional childbirth in rural jimma zone, oromia Ethiopia

Abstract

Background: Based on world health organization 2017 data globally nearly 295,000 women died during pregnancy and childbirth of which 196,000 deaths are reported in sub Saharan countries and 13,000 maternal deaths occurred in Ethiopia. So, the aim of this study was to explore the barriers and facilitators of community health actors and health professionals for making use of institutional childbirth during pregnancy, delivery and post-natal from the community and healthcare provider‟s perspective in three districts Woreda‟s of Jimma zone. Methods: An exploratory qualitative case study was conducted. The study was done in rural Jimma zone, Oromia Ethiopia. The data were collected 12focus group discussions (FGDs) and 24 in-depth interviews with purposely selected community members (Women, women development army (WDA), Religious leaders (RL), Health extension workers (HEW) ,Midwifery nurse, as well as primary health unit directors (PHCUDs) and MCH unit directors at PHCU. were conducted using local language Afanoromo and Amharic by using interview guide. The interviews were transcribed and translated in to English, and the data were analyzed using qualitative data management software (ATLAS.ti version 7.5.7.Thematic analysis was done. Results: From the analysis of Focus group discussions and in-depth interview data. knowledge; beliefs on pregnancy and delivery, poor access to health care services, poor quality of health services, lack of community‟s involvement and access to childbirth facilities. These themes were identified as rich and detailed accounts of the perspectives of institutional childbirth and the persistent home delivery from different perspectives [healthcare directors, health professionals, and from community leaders] in rural Jimma Zone, oromia Ethiopia. Conclusions and recommendation: The study reveals the barriers and facilitators to institutional childbirth service. It explored by five major themes cited by study participants which was knowledge; beliefs on pregnancy and delivery, poor access to health care services, poor quality of health care services, lack of community involvement and access to childbirth facilities. Regular monitoring and follow up is crucial to improve institutional child health delivery, as well as work collaboratively with multidisciplinary approach is increase the intention to use institutional child birth. The concern government body should avail different logistic services like transportation and different basic supplies.