Factors affecting the choice of delivery place in a rural area in Laos: A qualitative analysis

Autor: Tiengkham Pongvongsa, Miho Sato, Khamsamay Xaylovong, Yoshiko Kawaguchi, Kazuhiko Moji, Mitsuaki Matsui, Angkhana Lasaphonh, Nguyen Tien Huy, Ahmad M. Sayed, Atsuko Imoto, Sengchanh Kounnavong, Alliya Shafi
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Rural Population
Maternal Health
Social Sciences
Transportation
Health Services Accessibility
Geographical Locations
Labor and Delivery
0302 clinical medicine
Sociology
Residence Characteristics
Pregnancy
Medicine and Health Sciences
Psychology
Childbirth
030212 general & internal medicine
Human Families
Qualitative Research
Language
030219 obstetrics & reproductive medicine
Multidisciplinary
Geography
Obstetrics and Gynecology
Health Education and Awareness
Laos
Community health
language
Engineering and Technology
Medicine
Research Article
Adult
medicine.medical_specialty
Asia
Adolescent
Vietnamese
Science
Language barrier
Young Adult
03 medical and health sciences
medicine
Humans
business.industry
Parturition
Cognitive Psychology
Biology and Life Sciences
Focus group
language.human_language
Health Care
Child mortality
Health Care Facilities
Family medicine
People and Places
Birth
Women's Health
Cognitive Science
Rural area
Societies
business
Delivery of Health Care
Neuroscience
Qualitative research
Zdroj: PLoS ONE, Vol 16, Iss 8, p e0255193 (2021)
PLoS ONE
PLoS ONE, Vol 16, Iss 8 (2021)
ISSN: 1932-6203
Popis: Background: Home delivery (HD) without skilled birth attendants (SBAs) are considered crucial risk factors increasing maternal and child mortality rates in Loa PDR. While a few studies in the literature discuss the choice of delivery in remote areas of minority ethnic groups; our work aims to identify factors that indicated their delivery place, at home or in the health facilities. Methods: A community-based qualitative study was conducted between February and March 2020. Three types of interviews were implemented, In-depth interviews with 16 women of eight rural villages who delivered in the last 12 months in Xepon District, Savannakhet Province, Lao PDR. Also, three focus group discussions (FGDs) with nine HCPs and key-informant interviews of ten VHVs were managed. Factors affecting the choice of the delivery place were categorized according to the social-ecological model. Results: Our sample included five Tri women and two Mangkong women in the HD group, while the FD group included three Tri women, two Mangkong women, one Phoutai woman, two Laolung women and one Vietnamese. Our investigation inside the targeted minority showed that both positive perceptions of home delivery (HD) and low-risk perception minorities were the main reasons for the choice of HD, on the individual level. On the other hand, fear of complication, the experience of stillbirth, and prolonged labour pain during HD were reasons for facility-based delivery (FD). Notably, the women in our minority reported no link between their preference and their language, while the HCPs dated the low knowledge to the language barrier. On the interpersonal level, the FD women had better communication with their families, and better preparation for delivery compared to the HD group. The FD family prepared cash and transportation using their social network. At the community level, the trend of the delivery place had shifted from HD to FD. Improved accessibility and increased knowledge through community health education were the factors of the trend. At the societal (national policy) level, the free delivery policy and limitation of HCPs’ assisted childbirth only in health facilities were the factors of increasing FD, while the absence of other incentives like transportation and food allowance was the factor of remaining of HD. Conclusions: Based on the main findings of this study, we urge the enhancement of family communication on birth preparedness and birthplace. Furthermore, our findings support the need to educate mothers, especially those of younger ages, about their best options regarding the place of delivery. We propose implementing secondary services of HD to minimize the emergency risks of HD. We encourage local authorities to be aware of the medical needs of the community especially those of pregnant females and their right for a free delivery policy.
PLoS ONE, 16(8), art. no. e0255193; 2021
Databáze: OpenAIRE
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