Community-Based Situation Analysis of Maternal and Neonatal Care in South Africa to Explore Factors that Impact Utilization of Maternal Health Services

• Published in: Journal of midwifery & women's health 2007-07, Vol.52 (4), p.342-350
• Main Authors: Tlebere, Pulani, Jackson, Debra, Loveday, Marian, Matizirofa, Lyness, Mbombo, Nomafrench, Doherty, Tanya, Wigton, Alyssa, Treger, Latasha, Chopra, Mickey
• Format: Article
• Language: English
• Subjects: Adult; Community organizations; Female; Health Knowledge, Attitudes, Practice; Health Services Accessibility - statistics & numerical data; Health services utilization; HIV; HIV/AIDS; Human immunodeficiency virus; Humans; infant mortality; Infant, Newborn; Maternal Health Services - utilization; maternal mortality; Maternal Welfare - statistics & numerical data; maternity care; Midwifery; Midwifery - organization & administration; Mortality; Neonatal care; neonatal follow-up; Nursing; postpartum care; Postpartum period; Primary Health Care - statistics & numerical data; Research Design; Rural Health Services - statistics & numerical data; situation analysis; South Africa; utilization of health services; verbal autopsy; Womens health
• ISSN: 1526-9523; 1542-2011
• DOI: 10.1016/j.jmwh.2007.03.016

This community situational analysis determined factors impacting the utilization of maternal health services in South Africa. Quantitative and qualitative research methods were used, including semistructured household interviews, case studies of women with no antenatal care and/or home birth, and verbal/social autopsies of maternal and infant deaths, conducted in three diverse sites across the country. Data analysis used quantitative statistics for the semistructured interviews and a qualitative thematic content approach for the case studies and verbal/social autopsies. Each component was analyzed separately and then triangulated. The following themes emerged: 1) transport and distance to care were the biggest problems, particularly in rural areas; 2) providers’ communication with families was very poor; 3) health-seeking behavior was better than anticipated; 4) treatment by health providers and quality of care showed mixed results; 5) HIV/AIDS is a major issue; however, basic maternity and neonatal service quality cannot be overlooked; and 6) families and communities are an untapped resource for improving maternal and neonatal health. Implications for maternal and infant health care in developing countries are discussed, with a particular focus on barriers to utilization and involvement of communities and families in maternity care.