ArticleGates open research2025
Factors influencing the use of obstetric care during childbirth in rural Sudan: a qualitative study among healthcare providers.
Article in Gates open research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: It is estimated that over 287,000 women die annually from childbirth complications, with a substantial proportion living in sub-Saharan Africa. Access to professional obstetric care is crucial for averting these deaths, making it a global health priority. Urgency is heightened by limited literature regarding access to obstetric care, especially in Sudan's rural areas, where maternal mortality peaks. Therefore, the study objective was to identify the perceived barriers and facilitators of accessing obstetric services during childbirth in rural Sudan, specifically in Nuba Mountains, a conflict-ridden isolated region, from the perspective of health experts. Methods: An exploratory qualitative study was conducted from March to May 2023, involving remote in-depth interviews and online questionnaires with 11 health professionals working in maternal and reproductive health in rural Sudan. Thematic analysis was used for the data analysis. Results: Challenges in accessing professional obstetric care in rural Sudan are influenced by sociocultural factors, healthcare perceptions, surrounding individuals, and structural factors. The main barriers identified include social factors such as widespread acceptance of home birth, gender inequality, and family influence; structural barriers like long distances, lack of transport, a deficient referral system, and reliance on untrained healthcare workers; and individual-level factors including low health awareness and limited decision-making autonomy. These barriers are further compounded by political instability, conflict, and displacement in the Nuba Mountains, which severely constrains women's access to obstetric services. Conclusion: While many barriers align with existing literature, unique challenges in Nuba include centralized care, high acceptance of death, lack of a functioning communication network, and an unstable political situation.Barriers preventing women from seeking professional obstetric care during childbirth are complex, with particular challenges in Nuba due to its remoteness and political instability. Future assessments and improvements in care in Sudan should incorporate women's perspectives to ensure a more comprehensive and multidimensional approach.
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