ArticleBMC pregnancy and childbirth2018
Home deliveries in the capital: a qualitative exploration of barriers to institutional deliveries in peri-urban areas of Lusaka, Zambia.
Article in BMC pregnancy and childbirth, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Review
- Trends, spatial distribution and determinants of maternal home deliveries in Zambia.BMC pregnancy and childbirth · 2025Article
- Content validation and use of mothers on respect index to determine levels of respectful maternity care among women facing disadvantage, birthing in the Top End of the Northern Territory: a cross-sectional study.Frontiers in global women's health · 2025Article
- Trends and Inequalities in Maternal and Newborn Health Services for Unplanned Settlements of Lusaka City, Zambia.Journal of urban health : bulletin of the New York Academy of Medicine · 2024Article
- Understanding maternal choices and experiences of care by skilled providers: Voices of mothers who delivered at home in selected communities of Lusaka city, Zambia.Frontiers in global women's health · 2022Article
- The first 2 h after birth: prevalence and factors associated with neonatal care practices from a multicountry, facility-based, observational study.The Lancet. Global health · 2021Observational
- Confronting the culture of care: a call to end disrespect, discrimination, and detainment of women and newborns in health facilities everywhere.BMC pregnancy and childbirth · 2020Article
- Barriers to provision of respectful maternity care in Zambia: results from a qualitative study through the lens of behavioral science.BMC pregnancy and childbirth · 2020Article
- Traditional birth attendants' experiences during the provision of post-natal care in Mopani District, Limpopo province of South Africa.Health SA = SA Gesondheid · 2020Article
- The predictive power of health system environments: a novel approach for explaining inequalities in access to maternal healthcare.BMJ global health · 2019Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundA shortage of skilled birth attendants and low quality of care in health facilities along with unattended home deliveries contribute to the high maternal and neonatal mortality in sub Saharan Africa. Identifying and addressing context-specific reasons for not delivering at health care facilities could increase births assisted by skilled attendants who, if required, can provide life-saving interventions.
methodsWe conducted 22 in-depth interviews (IDIs) with midwives at three health facilities in peri-urban communities and 24 semi-structured surveys with mothers in two areas served by health facilities with the highest number of reported home deliveries in Lusaka, Zambia. Both IDIs and surveys were audio-recorded, transcribed and coded to identify themes around delivery and birthing experience.
resultsWe found that most women preferred institutional deliveries to home deliveries, but were unable to utilize these services due to inability to recognize labour symptoms or lack of resources. Midwives speculated that women used herbal concoctions to reduce the duration of delivery with the result that women either did not present in time or endangered themselves and the baby with powerful contractions and precipitous labour. Respondents suggested that disrespectful and abusive maternity care dissuaded some women from delivering at health facilities. However, some midwives viewed such tactics as necessary to ensure women followed instructions and successfully delivered live babies.
conclusionDifference in beliefs and birthing practices between midwives and mothers suggest the need for open dialogue to co-design appropriate interventions to increase facility usage. Further examination of the pharmaceutical properties and safety of herbal concoctions being used to shorten labour are required. Measures to reduce the economic burden of care seeking within this environment, increase respectful and patient-centred care, and improve the quality of midwifery could increase institutional deliveries.
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