Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.

<h4>Background</h4>South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Ru...

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Main Authors: Calistus Wilunda, Chiara Scanagatta, Giovanni Putoto, Risa Takahashi, Francesca Montalbetti, Giulia Segafredo, Ana Pilar Betrán
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168083&type=printable
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author Calistus Wilunda
Chiara Scanagatta
Giovanni Putoto
Risa Takahashi
Francesca Montalbetti
Giulia Segafredo
Ana Pilar Betrán
author_facet Calistus Wilunda
Chiara Scanagatta
Giovanni Putoto
Risa Takahashi
Francesca Montalbetti
Giulia Segafredo
Ana Pilar Betrán
author_sort Calistus Wilunda
collection DOAJ
description <h4>Background</h4>South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Rumbek North County.<h4>Methods</h4>Data were collected through 14 focus group discussions with 169 women and 45 men, and 18 key informant interviews with community leaders, staff working in health facilities, traditional birth attendants, and the staff of the County Health Department. Data were analysed using inductive content analysis.<h4>Results</h4>The barriers to institutional childbirth were categorised under four main themes: 1) Issues related to access and lack of resources: long distance to health facilities, lack of transportation means, referral problems, flooding and poor roads, and payments in health facilities; 2) Issues related to the socio-cultural context and conflict: insecurity, influence of the husband, lack of birth preparedness, domestic chores of women, influence of culture; 3) Perceptions about pregnancy and childbirth: perceived benefit of institutional childbirth, low childbirth risk perception, and medicalisation of childbirth including birth being perceived to be natural, undesirable birth practices, privacy concerns, and fear of caesarean section; and 4) Perceptions about the quality of care: inadequate health facility infrastructure and perceived neglect during admission.<h4>Conclusions</h4>Multiple factors hinder institutional childbirth in Rumbek North. Some of the factors such as insecurity and poor roads are outside the scope of the health sector and will require a multi-sectoral approach if childbirth services are to be made accessible to women. Detailed recommendations to increase utilisation of childbirth services in the county have been suggested.
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spelling doaj-art-1f5bdfd89d1c4617bab65949b50e22052025-08-20T03:26:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-011112e016808310.1371/journal.pone.0168083Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.Calistus WilundaChiara ScanagattaGiovanni PutotoRisa TakahashiFrancesca MontalbettiGiulia SegafredoAna Pilar Betrán<h4>Background</h4>South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Rumbek North County.<h4>Methods</h4>Data were collected through 14 focus group discussions with 169 women and 45 men, and 18 key informant interviews with community leaders, staff working in health facilities, traditional birth attendants, and the staff of the County Health Department. Data were analysed using inductive content analysis.<h4>Results</h4>The barriers to institutional childbirth were categorised under four main themes: 1) Issues related to access and lack of resources: long distance to health facilities, lack of transportation means, referral problems, flooding and poor roads, and payments in health facilities; 2) Issues related to the socio-cultural context and conflict: insecurity, influence of the husband, lack of birth preparedness, domestic chores of women, influence of culture; 3) Perceptions about pregnancy and childbirth: perceived benefit of institutional childbirth, low childbirth risk perception, and medicalisation of childbirth including birth being perceived to be natural, undesirable birth practices, privacy concerns, and fear of caesarean section; and 4) Perceptions about the quality of care: inadequate health facility infrastructure and perceived neglect during admission.<h4>Conclusions</h4>Multiple factors hinder institutional childbirth in Rumbek North. Some of the factors such as insecurity and poor roads are outside the scope of the health sector and will require a multi-sectoral approach if childbirth services are to be made accessible to women. Detailed recommendations to increase utilisation of childbirth services in the county have been suggested.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168083&type=printable
spellingShingle Calistus Wilunda
Chiara Scanagatta
Giovanni Putoto
Risa Takahashi
Francesca Montalbetti
Giulia Segafredo
Ana Pilar Betrán
Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.
PLoS ONE
title Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.
title_full Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.
title_fullStr Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.
title_full_unstemmed Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.
title_short Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.
title_sort barriers to institutional childbirth in rumbek north county south sudan a qualitative study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0168083&type=printable
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