A qualitative study of women’s experience and perceptions of using Skilled Birth Attendants in rural Nepal.

Abstract

Background: Access of health services such as transportation, cost of the services, women’s autonomy, community influences, socio-cultural and gender roles in decision-making are discussed repeatedly. However, women’s own perceptions and experiences are poorly explored during service use and health services development. This study aimed to explore women’s experiences and perceptions in the use of SBA during the pregnancy and childbirth in rural Nepal. Methods: Semi-structured interviews were conducted. The data were analysed using the thematic analysis. The fieldwork was conducted in a village of western Nepal. Interviews were conducted with 24 married women aged 18-49 who had given birth within the three years at the ti me of study. Results: Health service providers’ attitude and behaviour towards women during service use appeared one of the important factors in skilled birth attendants’ use. Positive behaviour from health service providers encouraged women to service use while negative behaviour discouraged. Lack of privacy and confidentiality discouraged women to use skilled delivery care. Women expected friendly and respective care but findings show that women were not happy of the services they received during skilled care used. Conclusion: This study contributes to understanding why women do or do not use Skilled Birth Attendants. Women who had attended hospital in order to receive care by skilled birth attendants generally described this as a negative experience, due to poor quality of services and rude behaviour of female service providers. Many of the participants said that they would prefer to have their babies at home, if they had access to skilled care in their local area.