Maternal health care professionals´ perspectives on the provision and use of antenatal and delivery care: a qualitative descriptive study in rural Vietnam
Författare och institution:
Sophie Graner (-); Inger Mogren (-); Le Q Duong (-); Gunilla Krantz (Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa); Marie Klingberg-Allvin (-)
BMC Public Health, 14 ( 10 ) s. art: 608
Artikel, refereegranskad vetenskaplig
Background: High quality maternal health care is an important tool to reduce maternal and neonatal mortality.
Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study
explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content
and quality of maternal health care in rural Vietnam.
Method: The study was performed in a rural district in northern Vietnam. Four focus group discussions with health
care professionals at primary health care level were conducted. The data was analysed using qualitative manifest
and latent content analysis.
Result: Two main themes emerged: “Contextual conditions for maternal health care” and “Balancing between
possibilities and constraints”. Contextual conditions influenced both pregnant women’s use of maternal health care
and health care professionals’ performance. The study participants stated that women’s uses of maternal health
care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to
childbearing. Structural constraints within the health care system included inadequate financing of the primary
health care, resulting in lack of human resources, professional re-training and adequate equipment.
Conclusion: Contextual conditions strongly influenced the performance and interaction between pregnant women
and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although
Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed
midwives’ and other health care professionals’ perceived difficulties in their daily work. It seemed maternal health
care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in
Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women’s autonomy and
reduce their possibility to make independent decisions about their own reproductive health. This issue should be
further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are
needed. The quality of client-provider interaction and management of pregnancy may be strengthened by
education, human resources, re-training and provision of essential equipment.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ->
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