Risky health seeking practice among pregnant women in rural Congo: The women's behavior of bypassing the well equipped maternity clinic, is leading to health complication,s with high rates of mortality and morbidity for both mother and child.

Danish University Colleges

Risky health seeking practice among pregnant women in rural Congo

The women's behavior of bypassing the well equipped maternity clinic, is leading to health complication,s with high rates of mortality and morbidity for both mother and child.

Hørby, Laila

Publication date:

2007

Document Version

Early version, also known as preprint Link to publication

Citation for pulished version (APA):

Hørby, L. (2007). Risky health seeking practice among pregnant women in rural Congo: The women's behavior of bypassing the well equipped maternity clinic, is leading to health complication,s with high rates of mortality and morbidity for both mother and child.

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FURTHER RECOMMENDATIONS:

- Integrate the TBAs in the work of perinatal care:

- let them start women’s groups meetings with prenatal care awareness and empowering education in the villages.

- let them do home deliveries with the supernormal women, just like we do it in the west.

- support them with equipment, medication, back up and supervision from the maternity.

- Involve them in the registration and statistics of births and deaths and let them take part in verbal audits in homes, which will be of benefit for everybody.

- Let the women pay at the maternity as they pay the TBAs: in Kind (Goods ex. food).

- Arrange special rooms and special treatment for the

wealthier women and let them pay enough to cover for the poorer women.

- Let the women stay 5 days at the maternity and let the TBA pay home visits twice post partum.

- Finally I recommend the staff to be organized to work for their rights and a better working environment with further training.

HEALTH PROMOTING MIDWIFERY

Risky health seeking practice among pregnant women in rural Congo

Laila Hørby, RN, RM, MIH, lecturer at University College of North Jutland, Department of Midwifery, Denmark, e-mail: lah@ucn.dk

METHOD:

A fieldwork study using qualitative methods such as interviews, focus group discussions (FGD) and observations of agents in the field of pregnancy and childbirth.

I’ve done a descriptive and analytical study of the views and needs of the women and of the practices and reasoning’s of both the TBA’s and the trained midwifes. All is analyzed by the use of a Bourdieu inspired framework and terminology.

The WHO Millennium

Development Goal number 5:

Improve maternal health by 2015.

Reduce by three quarters, between 1990 and 2015 the maternal mortality ratios.

Achieve by 2015 universal access to reproductive health.

A STUDY OF...

- Pregnant women’s health seeking practice in the villages around Mulungwishi, a school

center in rural Congo.

- The women’s behavior of bypassing the well equipped maternity clinic, with the profes- sional staff of midwifes just a few km. away, and thus choosing to stay in an unhygienic environment, to give birth, with an untrained birth attendant as assistant, is leading to

health complications with high rates of

mortality and morbidity for both mother and child.

AIM OF STUDY:

I wanted to try to explain the difference between two groups of women, those who seek help with the Traditional Birth

Attendants (TBA) and those who seek help at the maternity with the professional staff, as first choice.

The desired long time outcome of this study was a more

relevant ante and perinatal care practice, with lower mortality and morbidity, among the women at childbearing age, in the villages in rural Congo.

RESULTS:

- The women’s choices are driven by their poverty. But free care does not solve the problem of high mortality rate if the

women do not know what sign of danger and symptoms to react on.

- The key persons to engage in developing a more relevant ante, peri and post natal care practice, are the TBAs and it will be important to work with the TBAs.

THE TBAS:

- The TBAs are there, they are part of the folk sector, part of the culture of the women, the women use, trust and respect them and they have something important to offer: They are cultu- rally sensitive, knowledgeable & they like what they do.

- We need to recognize the TBAs as equal players in this field of pregnancy and childbirth.

I RECOMMEND:

- Training at all levels! My research assistant, a TBA, said:

“Educate a woman and you educate a nation.”

MATERNAL MORTALITY RATIO

CAUSES OF MATERNAL DEATH

Source: The World Health Report 2005. Make every mother and child count. Geneva, World Health Organization 2005 Source: The World Health Report 2005. Make every mother and child count.

Geneva, World Health Organization 2005