ArticleQuality & safety in health care2006
Getting women to hospital is not enough: a qualitative study of access to emergency obstetric care in Bangladesh.
Article in Quality & safety in health care, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Socioeconomic inequalities in access to maternal healthcare in South-Asian countries: A systematic review.PloS one · 2025Pooled it
- Factors that influence the provision of intrapartum and postnatal care by skilled birth attendants in low- and middle-income countries: a qualitative evidence synthesis.The Cochrane database of systematic reviews · 2017Pooled it
- Facilitators and barriers to facility-based delivery in low- and middle-income countries: a qualitative evidence synthesis.Reproductive health · 2014Pooled it
- Why are women dying when they reach hospital on time? A systematic review of the 'third delay'.PloS one · 2013Pooled it
- Maternal and newborn healthcare utilization in Kampala urban slums: perspectives of women, their spouses, and healthcare providers.BMC pregnancy and childbirth · 2023Article
- A novel approach to frontline health worker support: a case study in increasing social power among private, fee-for-service birthing attendants in rural Bangladesh.Human resources for health · 2023Article
- Emergency medical services in rural and urban Saudi Arabia: A qualitative study of Red Crescent emergency personnel' perceptions of workforce and patient factors impacting effective delivery.Health & social care in the community · 2022Article
- "We Tried to Borrow Money, but No One Helped." Assessing the Three-Delay Model Factors Affecting the Healthcare Service Delivery among Dengue Patients during COVID-19 Surge in a Public Tertiary Hospital: A Convergent Parallel Mixed Methods Study.International journal of environmental research and public health · 2021Article
- Non-pharmacological interventions of pain management used during labour; an exploratory descriptive qualitative study of puerperal women in Adidome Government Hospital of the Volta Region, Ghana.Reproductive health · 2021Article
- Are we entering a new era for qualitative research? Using qualitative evidence to support guidance and guideline development by the World Health Organization.International journal for equity in health · 2018Article
- Emergency transport for obstetric emergencies: integrating community-level demand creation activities for improved access to maternal, newborn, and child health services in northern Nigeria.International journal of women's health · 2018Article
- Prevalence of disrespect and abuse of women during child birth and associated factors in Bahir Dar town, Ethiopia.Epidemiology and health · 2018Article
- Going to scale: design and implementation challenges of a program to increase access to skilled birth attendants in Nigeria.BMC health services research · 2017Article
- Article
- Costs of integrating demand-based reproductive health commodity model into the Government and NGO service delivery systems in Bangladesh: a supply side perspective.SpringerPlus · 2015Article
- Pregnancy-related health information-seeking behaviors among rural pregnant women in India: validating the Wilson model in the Indian context.The Yale journal of biology and medicine · 2014Article
- A spatial analysis to study access to emergency obstetric transport services under the public private "Janani Express Yojana" program in two districts of Madhya Pradesh, India.Reproductive health · 2014Article
- Investigating the role of health care at birth on inequalities in neonatal survival: evidence from Bangladesh.International journal for equity in health · 2013Article
- Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour.BMC pregnancy and childbirth · 2011Article
- Individual and health facility factors and the risk for obstructed labour and its adverse outcomes in south-western Uganda.BMC pregnancy and childbirth · 2011Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo explore what happened to poor women in Bangladesh once they reached a hospital providing comprehensive emergency obstetric care (EmOC) and to identify support mechanisms.
designMixed methods qualitative study.
settingLarge government medical college hospital in Bangladesh. SAMPLE: Providers and users of EmOC.
methodsEthnographic observation in obstetrics unit including interviews with staff and women using the unit and their carers.
resultsWomen had to mobilise significant financial and social resources to fund out of pocket expenses. Poorer women faced greater challenges in receiving treatment as relatives were less able to raise the necessary cash. The official financial support mechanism was bureaucratic and largely unsuitable in emergency situations. Doctors operated a less formal "poor fund" system to help the poorest women. There was no formal assessment of poverty; rather, doctors made "adjudications" of women's need for support based on severity of condition and presence of friends and relatives. Limited resources led to a "wait and see" policy that meant women's condition could deteriorate before help was provided.
conclusionsGreater consideration must be given to what happens at health facilities to ensure that (1) using EmOC does not further impoverish families; and (2) the ability to pay does not influence treatment. Developing alternative finance mechanisms to reduce the burden of out of pocket expenses is crucial but challenging. Increased investment in EmOC must be accompanied by an increased focus on equity.
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