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Factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern Tajikistan

BACKGROUND: This qualitative study aimed to investigate the health seeking behaviour of rural women in northern Tajikistan, with specific focus on antenatal and obstetric complications as a result of delayed access to health services. Due to the unprecedented level of labour migration among men in t...

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Autores principales: Nabieva, Jamila, Souares, Aurélia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323767/
https://www.ncbi.nlm.nih.gov/pubmed/30616530
http://dx.doi.org/10.1186/s12884-018-2166-6
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author Nabieva, Jamila
Souares, Aurélia
author_facet Nabieva, Jamila
Souares, Aurélia
author_sort Nabieva, Jamila
collection PubMed
description BACKGROUND: This qualitative study aimed to investigate the health seeking behaviour of rural women in northern Tajikistan, with specific focus on antenatal and obstetric complications as a result of delayed access to health services. Due to the unprecedented level of labour migration among men in the border region of Tajikistan, Isfara, the study specifically focused on migrants’ wives residing with their in-laws. METHODS: Using an adapted “Three delays” model which suggests three major causes of delayed access to maternity services - decision to seek care, reaching a healthcare facility and receiving necessary care – we conducted 29 in-depth interviews with labour migrants’ wives, 16 semi-structured interviews with healthcare service providers and 2 focus-group discussions with 16 mothers-in-law in Isfara district. RESULTS: Our study demonstrated that the most crucial and conditioned factor of access to maternity services for labour migrants’ wives is a decision to seek care. While reaching a healthcare facility (geographical accessibility, time and transportation costs) and receiving necessary care (availability of services, financial affordability and perceived quality of care) were rarely reported as obstacles towards timely access to maternity services, decision to seek care was found to be an intricate interplay of several factors: traditional gender and family roles (particularly in the absence of the husband), the age of the mother-in-law, cultural beliefs and perceptions about pregnancy and maternity, and widely spread myths about certain health conditions and services. CONCLUSIONS: Our study concludes that the traditional pattern of seeking health care among women in northern Tajikistan may often cause delays in accessing necessary maternity services and result in adverse health outcomes for women. We suggest that effective strategies to reduce maternal morbidity and mortality in rural Tajikistan should, along with strengthening healthcare structures, embark on community education and awareness raising with special focus on mothers-in-law and other traditional decision-makers in households.
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spelling pubmed-63237672019-01-11 Factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern Tajikistan Nabieva, Jamila Souares, Aurélia BMC Pregnancy Childbirth Research Article BACKGROUND: This qualitative study aimed to investigate the health seeking behaviour of rural women in northern Tajikistan, with specific focus on antenatal and obstetric complications as a result of delayed access to health services. Due to the unprecedented level of labour migration among men in the border region of Tajikistan, Isfara, the study specifically focused on migrants’ wives residing with their in-laws. METHODS: Using an adapted “Three delays” model which suggests three major causes of delayed access to maternity services - decision to seek care, reaching a healthcare facility and receiving necessary care – we conducted 29 in-depth interviews with labour migrants’ wives, 16 semi-structured interviews with healthcare service providers and 2 focus-group discussions with 16 mothers-in-law in Isfara district. RESULTS: Our study demonstrated that the most crucial and conditioned factor of access to maternity services for labour migrants’ wives is a decision to seek care. While reaching a healthcare facility (geographical accessibility, time and transportation costs) and receiving necessary care (availability of services, financial affordability and perceived quality of care) were rarely reported as obstacles towards timely access to maternity services, decision to seek care was found to be an intricate interplay of several factors: traditional gender and family roles (particularly in the absence of the husband), the age of the mother-in-law, cultural beliefs and perceptions about pregnancy and maternity, and widely spread myths about certain health conditions and services. CONCLUSIONS: Our study concludes that the traditional pattern of seeking health care among women in northern Tajikistan may often cause delays in accessing necessary maternity services and result in adverse health outcomes for women. We suggest that effective strategies to reduce maternal morbidity and mortality in rural Tajikistan should, along with strengthening healthcare structures, embark on community education and awareness raising with special focus on mothers-in-law and other traditional decision-makers in households. BioMed Central 2019-01-07 /pmc/articles/PMC6323767/ /pubmed/30616530 http://dx.doi.org/10.1186/s12884-018-2166-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Nabieva, Jamila
Souares, Aurélia
Factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern Tajikistan
title Factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern Tajikistan
title_full Factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern Tajikistan
title_fullStr Factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern Tajikistan
title_full_unstemmed Factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern Tajikistan
title_short Factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern Tajikistan
title_sort factors influencing decision to seek health care: a qualitative study among labour-migrants’ wives in northern tajikistan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6323767/
https://www.ncbi.nlm.nih.gov/pubmed/30616530
http://dx.doi.org/10.1186/s12884-018-2166-6
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