ArticleReproductive health2018
Too afraid to go: fears of dignity violations as reasons for non-use of maternal health services in South Sudan.
Article in Reproductive health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Barriers and facilitators to maternal healthcare in East Africa: a systematic review and qualitative synthesis of perspectives from women, their families, healthcare providers, and key stakeholders.BMC pregnancy and childbirth · 2025Pooled it
- Disrespect and abuse as a predictor of postnatal care utilisation and maternal-newborn well-being: a mixed-methods systematic review.BMJ global health · 2021Pooled it
- Woman-centred care in conflict-affected and fragile states: a scoping review of policy integration and implementation gaps in the greater horn of Africa.Reproductive health · 2026Article
- Article
- Obstetric violence informed by theories of intersectionality, oppression, and power dynamics-a Ghanaian's perspectives.AJOG global reports · 2025Article
- Exploring care-seeking practices within a family mid-upper arm circumference approach in South Sudan: a mixed-methods prospective study.BMC public health · 2025Article
- Determinants of health seeking behaviour in South Sudan: a cross-sectional household survey.BMC public health · 2025Article
- Perspectives on midwife-led care as a solution to reduce obstetric violence in health facilities in Ghana.Frontiers in global women's health · 2025Article
- Key barriers to the provision and utilization of maternal health services in low-and lower-middle-income countries; a scoping review.BMC women's health · 2024Article
- "Midwives are heroes of the country": qualitative evaluation of a midwifery education program in South Sudan.Frontiers in global women's health · 2023Article
- Creating an Agenda for Black Birth Equity: Black Voices Matter.Health equity · 2023Article
- Cultural adaptation and psychometric evaluation of Childbirth Experience Questionnaire 2 in Karnataka state, India.PloS one · 2023Article
- Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations.Conflict and health · 2022Review
- Health system bottlenecks hindering provision of supportive and dignified maternity care in public health facilities.PLOS global public health · 2022Article
- Risk Factors for Positive Appraisal of Mistreatment during Childbirth among Ethiopian Midwifery Students.International journal of environmental research and public health · 2020Article
- Health policy mapping and system gaps impeding the implementation of reproductive, maternal, neonatal, child, and adolescent health programs in South Sudan: a scoping review.Conflict and health · 2020Article
- Mothers' experiences of quality of care and potential benefits of implementing the WHO safe childbirth checklist: a case study of Aceh Indonesia.BMC pregnancy and childbirth · 2019Article
- Determinants of Health Facility Utilization at Birth in South Sudan.International journal of environmental research and public health · 2019Article
- The Giving Voice to Mothers study: inequity and mistreatment during pregnancy and childbirth in the United States.Reproductive health · 2019Article
- 'You have a child who will call you "mama" ': understanding adolescent pregnancy in South Sudan.Global health action · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSouth Sudan has one of the worst health and maternal health situations in the world. Across South Sudan, while maternal health services at the primary care level are not well developed, even where they exist, many women do not use them. Developing location specific understanding of what hinders women from using services is key to developing and implementing locally appropriate public health interventions.
methodsA qualitative study was conducted to gain insight into what hinders women from using maternal health services. Focus group discussions (5) and interviews (44) were conducted with purposefully selected community members and health personnel. A thematic analysis was done to identify key themes.
resultsWhile accessibility, affordability, and perceptions (need and quality of care) related barriers to the use of maternal health services exist and are important, women's decisions to use services are also shaped by a variety of social fears. Societal interactions entailed in the process of going to a health facility, interactions with other people, particularly other women on the facility premises, and the care encounters with health workers, are moments where women are afraid of experiencing dignity violations. Women's decisions to step out of their homes to seek maternal health care are the results of a complex trade-off they make or are willing to make between potential threats to their dignity in the various social spaces they need to traverse in the process of seeking care, their views on ownership of and responsibility for the unborn, and the benefits they ascribe to the care available to them.
conclusionsGeographical accessibility, affordability, and perceptions related barriers to the use of maternal health services in South Sudan remain; they need to be addressed. Explicit attention also needs to be paid to address social accessibility related barriers; among others, to identify, address and allay the various social fears and fears of dignity violations that may hold women back from using services. Health services should work towards transforming health facilities into social spaces where all women's and citizen's dignity is protected and upheld.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.