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Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana

BACKGROUND: This study was undertaken to investigate women's accounts of interactions with health care providers during labour and delivery and to assess the implications for acceptability and utilisation of maternity services in Ghana. METHODS: Twenty-one individual in-depth interviews and two...

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Detalles Bibliográficos
Autores principales: D'Ambruoso, Lucia, Abbey, Mercy, Hussein, Julia
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1343547/
https://www.ncbi.nlm.nih.gov/pubmed/16372911
http://dx.doi.org/10.1186/1471-2458-5-140
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author D'Ambruoso, Lucia
Abbey, Mercy
Hussein, Julia
author_facet D'Ambruoso, Lucia
Abbey, Mercy
Hussein, Julia
author_sort D'Ambruoso, Lucia
collection PubMed
description BACKGROUND: This study was undertaken to investigate women's accounts of interactions with health care providers during labour and delivery and to assess the implications for acceptability and utilisation of maternity services in Ghana. METHODS: Twenty-one individual in-depth interviews and two focus group discussions were conducted with women of reproductive age who had delivered in the past five years in the Greater Accra Region. The study investigated women's perceptions and experiences of care in terms of factors that influenced place of delivery, satisfaction with services, expectations of care and whether they would recommend services. RESULTS: One component of care which appeared to be of great importance to women was staff attitudes. This factor had considerable influence on acceptability and utilisation of services. Otherwise, a successful labour outcome and non-medical factors such as cost, perceived quality of care and proximity of services were important. Our findings indicate that women expect humane, professional and courteous treatment from health professionals and a reasonable standard of physical environment. Women will consciously change their place of delivery and recommendations to others if they experience degrading and unacceptable behaviour. CONCLUSION: The findings suggest that inter-personal aspects of care are key to women's expectations, which in turn govern satisfaction. Service improvements which address this aspect of care are likely to have an impact on health seeking behaviour and utilisation. Our findings suggest that user-views are important and warrant further investigation. The views of providers should also be investigated to identify channels by which service improvements, taking into account women's views, could be operationalised. We also recommend that interventions to improve delivery care should not only be directed to the health professional, but also to general health system improvements.
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spelling pubmed-13435472006-01-21 Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana D'Ambruoso, Lucia Abbey, Mercy Hussein, Julia BMC Public Health Research Article BACKGROUND: This study was undertaken to investigate women's accounts of interactions with health care providers during labour and delivery and to assess the implications for acceptability and utilisation of maternity services in Ghana. METHODS: Twenty-one individual in-depth interviews and two focus group discussions were conducted with women of reproductive age who had delivered in the past five years in the Greater Accra Region. The study investigated women's perceptions and experiences of care in terms of factors that influenced place of delivery, satisfaction with services, expectations of care and whether they would recommend services. RESULTS: One component of care which appeared to be of great importance to women was staff attitudes. This factor had considerable influence on acceptability and utilisation of services. Otherwise, a successful labour outcome and non-medical factors such as cost, perceived quality of care and proximity of services were important. Our findings indicate that women expect humane, professional and courteous treatment from health professionals and a reasonable standard of physical environment. Women will consciously change their place of delivery and recommendations to others if they experience degrading and unacceptable behaviour. CONCLUSION: The findings suggest that inter-personal aspects of care are key to women's expectations, which in turn govern satisfaction. Service improvements which address this aspect of care are likely to have an impact on health seeking behaviour and utilisation. Our findings suggest that user-views are important and warrant further investigation. The views of providers should also be investigated to identify channels by which service improvements, taking into account women's views, could be operationalised. We also recommend that interventions to improve delivery care should not only be directed to the health professional, but also to general health system improvements. BioMed Central 2005-12-22 /pmc/articles/PMC1343547/ /pubmed/16372911 http://dx.doi.org/10.1186/1471-2458-5-140 Text en Copyright © 2005 D'Ambruoso et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
D'Ambruoso, Lucia
Abbey, Mercy
Hussein, Julia
Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana
title Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana
title_full Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana
title_fullStr Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana
title_full_unstemmed Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana
title_short Please understand when I cry out in pain: women's accounts of maternity services during labour and delivery in Ghana
title_sort please understand when i cry out in pain: women's accounts of maternity services during labour and delivery in ghana
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1343547/
https://www.ncbi.nlm.nih.gov/pubmed/16372911
http://dx.doi.org/10.1186/1471-2458-5-140
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