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Barriers to birth preparedness and antenatal-care attendance according to the three delays model [22,23], in Busoga, Eastern Uganda |
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| DELAY |
BARRIER |
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| DELAY 1: DELAY TO SEEK CARE |
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| Knowledge Barriers |
- ANC misconstrued as provision of medicine for sick pregnant women - Limited community knowledge on: importance of attending ANC four times; importance of ANC to mother and unborn baby; cause and care for danger signs |
| Culture and traditional beliefs and practices |
- Deep rooted beliefs in herbs as part of pregnancy care - Decision making as a male prerogative (seeking and choice of care) - Conflicts related to polygamy: men making preferential treatment among wives - Mother-in-laws making decisions for daughter-in-laws - Influence from older mothers - Too much burden of work on women - The fear of preparing for the unborn whose viability is considered uncertain |
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| DELAY 2: DELAY TO ARRIVE AT A HEALTH UNIT |
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| Financial Constraints |
- Lack of money for transport and hospital related costs (including under the table payments) - Women's reliance on male partners for funds and men unable to raise and sometimes unwilling to give the funds - Health facility requirements for BP being too costly for families |
| Peer influence on choice of care |
- Women relying on fellow women for advise on ANC attendance |
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| DELAY 3: DELAY TO GET CARE ONCE AT A HEALTH UNIT |
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| Service delivery gaps |
- Emphasis on ANC card by health workers as a pre-condition to skilled care - Lack of skilled staff - Poor attitude and communication skills of health workers e.g. rudeness and ignoring clients - Health workers do not actively encourage couples to choose skilled providers for delivery |
Waiswa et al. BMC Pregnancy and Childbirth 2008 8:21 doi:10.1186/1471-2393-8-21 |
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