Challenges of maternity continuum of care within the primary health care in northwest Ethiopia: interpretive description using a socio-ecological model
BackgroundThe maternity continuum of care plays a vital role in improving maternal and neonatal outcomes. However, its uptake remains low in Ethiopia, highlighting the need to identify challenges within the primary health care system to inform practice. Hence, this study aimed to explore the challen...
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| Format: | Article |
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1401988/full |
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| author | Muhabaw Shumye Mihret Kassahun Alemu Debrework Tesgera Beshah Lemma Derseh Gezie Kerstin Erlandsson Kerstin Erlandsson Helena Lindgren Helena Lindgren |
| author_facet | Muhabaw Shumye Mihret Kassahun Alemu Debrework Tesgera Beshah Lemma Derseh Gezie Kerstin Erlandsson Kerstin Erlandsson Helena Lindgren Helena Lindgren |
| author_sort | Muhabaw Shumye Mihret |
| collection | DOAJ |
| description | BackgroundThe maternity continuum of care plays a vital role in improving maternal and neonatal outcomes. However, its uptake remains low in Ethiopia, highlighting the need to identify challenges within the primary health care system to inform practice. Hence, this study aimed to explore the challenges of the maternity continuum of care within the primary health care system in northwest Ethiopia.MethodsAn interpretive description approach was employed from March 3, 2022, to November 27, 2022, within the primary health care system in northwest Ethiopia. Maximum variation sampling was utilized, comprising 28 in-depth interviews, three focus group discussions with 29 participants, and four key informant interviews. The reflexive thematic analysis method was applied, and the results were mapped onto the constructs of the socio-ecological model.ResultsThe analysis identified four main themes: low maternity healthcare-seeking behavior (intrapersonal level), lack of peer and family support (interpersonal level), cultural influences on maternity care and low community responsiveness (community level), and inadequate health system readiness and response (health facility/system level). Some of the sub-themes include low health literacy and self-efficacy and misconceptions regarding maternity care at the intrapersonal level; peer and family pressure against seeking maternity care, low autonomy, and intimate partner violence at the interpersonal level; cultural influences on pregnancy disclosure and postnatal care and low social accountability at the community level; and delays in accessing ambulance services, long waiting times for maternity care, shortages of essential healthcare supplies, poor coordination of care, inadequate monitoring and evaluation, disrespectful maternity care, and dissatisfaction among healthcare workers at the health facility/system level.ConclusionIntrapersonal, interpersonal, community, and health facility- and system-level challenges have influenced the maternity continuum of care within the primary health care in northwest Ethiopia. Since these challenges are interdependent, considering a holistic approach within primary health care could lead to an improved maternity continuum of care. |
| format | Article |
| id | doaj-art-132096b0eb0845b5b3deae41daaa596f |
| institution | OA Journals |
| issn | 2296-2565 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-132096b0eb0845b5b3deae41daaa596f2025-08-20T02:39:03ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-12-011210.3389/fpubh.2024.14019881401988Challenges of maternity continuum of care within the primary health care in northwest Ethiopia: interpretive description using a socio-ecological modelMuhabaw Shumye Mihret0Kassahun Alemu1Debrework Tesgera Beshah2Lemma Derseh Gezie3Kerstin Erlandsson4Kerstin Erlandsson5Helena Lindgren6Helena Lindgren7Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaDepartment of Women’s and Children’s Health, Karolinska Institutet, Stockholm, SwedenDepartment for Health and Welfare, Dalarna University and School of Health and Welfare, Dalarna University, Borlange, SwedenDepartment of Women’s and Children’s Health, Karolinska Institutet, Stockholm, SwedenDepartment of Health Promotion, Sophiahemmet University, Stockholm, SwedenBackgroundThe maternity continuum of care plays a vital role in improving maternal and neonatal outcomes. However, its uptake remains low in Ethiopia, highlighting the need to identify challenges within the primary health care system to inform practice. Hence, this study aimed to explore the challenges of the maternity continuum of care within the primary health care system in northwest Ethiopia.MethodsAn interpretive description approach was employed from March 3, 2022, to November 27, 2022, within the primary health care system in northwest Ethiopia. Maximum variation sampling was utilized, comprising 28 in-depth interviews, three focus group discussions with 29 participants, and four key informant interviews. The reflexive thematic analysis method was applied, and the results were mapped onto the constructs of the socio-ecological model.ResultsThe analysis identified four main themes: low maternity healthcare-seeking behavior (intrapersonal level), lack of peer and family support (interpersonal level), cultural influences on maternity care and low community responsiveness (community level), and inadequate health system readiness and response (health facility/system level). Some of the sub-themes include low health literacy and self-efficacy and misconceptions regarding maternity care at the intrapersonal level; peer and family pressure against seeking maternity care, low autonomy, and intimate partner violence at the interpersonal level; cultural influences on pregnancy disclosure and postnatal care and low social accountability at the community level; and delays in accessing ambulance services, long waiting times for maternity care, shortages of essential healthcare supplies, poor coordination of care, inadequate monitoring and evaluation, disrespectful maternity care, and dissatisfaction among healthcare workers at the health facility/system level.ConclusionIntrapersonal, interpersonal, community, and health facility- and system-level challenges have influenced the maternity continuum of care within the primary health care in northwest Ethiopia. Since these challenges are interdependent, considering a holistic approach within primary health care could lead to an improved maternity continuum of care.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1401988/fullchallengesmaternity continuum of carematernity servicesinterpretive descriptionprimary health care |
| spellingShingle | Muhabaw Shumye Mihret Kassahun Alemu Debrework Tesgera Beshah Lemma Derseh Gezie Kerstin Erlandsson Kerstin Erlandsson Helena Lindgren Helena Lindgren Challenges of maternity continuum of care within the primary health care in northwest Ethiopia: interpretive description using a socio-ecological model Frontiers in Public Health challenges maternity continuum of care maternity services interpretive description primary health care |
| title | Challenges of maternity continuum of care within the primary health care in northwest Ethiopia: interpretive description using a socio-ecological model |
| title_full | Challenges of maternity continuum of care within the primary health care in northwest Ethiopia: interpretive description using a socio-ecological model |
| title_fullStr | Challenges of maternity continuum of care within the primary health care in northwest Ethiopia: interpretive description using a socio-ecological model |
| title_full_unstemmed | Challenges of maternity continuum of care within the primary health care in northwest Ethiopia: interpretive description using a socio-ecological model |
| title_short | Challenges of maternity continuum of care within the primary health care in northwest Ethiopia: interpretive description using a socio-ecological model |
| title_sort | challenges of maternity continuum of care within the primary health care in northwest ethiopia interpretive description using a socio ecological model |
| topic | challenges maternity continuum of care maternity services interpretive description primary health care |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1401988/full |
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