Title:
Utilization of Institutional Delivery Services and Skilled Birth Attendants by Rural Women in Bhutan
Authors:
Karki, Roma
Year:
2015
PAGE:
xiii, 51
Language:
En
Subject:
Maternal Health – Lessons Learned
Keywords:
Utilization, Institutional Delivery Services, Skilled Birth Attendants, Rural Women, Bhutan
Abstract:
Background: Bhutan is on track in achieving MDG of reducing maternal mortality ratio by two-third, with MMR of 120 per 100,000 live births in 2013, with 87% decline since 1990. The rate of skilled delivery increased rapidly reaching 74.6% in 2012, however, disparity still exists among districts and between urban-rural women in the utilization of skilled delivery services with 33.7% rural women still delivering at home. Objective: To assess factors associated with the use of delivery services and SBA during childbirth by rural women and to identify and recommend evidence based interventions as learnt from other countries to improve utilization of delivery services. Method: Literature review was conducted using peer reviewed and grey literature from SEA countries and Bhutan. To analyze the influencing factors, conceptual framework adapted from three delay model by Gabrysch and Campbell was used. Results: Low education, poorer household, lower maternal age, rural residence, cultural beliefs and practices, and too far distance from health facility with inadequate transportation, poor perception of benefits of skilled delivery are common factors discouraging women to use delivery services in Bhutan. Poor quality of ANC services, unavailability of waiting home and food in BHUs, and inadequate capacity of health facility to render emergency obstetric care due to retention and shortage of HWs are health service factors deterring women from delivery service utilization. To improve utilization by rural women, interventions like maternity waiting home, demand side financing and community participation are found to be effective. Conclusion and recommendations: To increase the use of delivery services by rural women, Bhutan should bring in policy changes to institute effective interventions and promising practices targeted to these areas and continue to improve access to EmOC services. Introduction of cash incentives, maternity gift, waiting room/home with cooking facilities/food provision, promoting deliveries in BHUs and expansion of community participation are proposed to bring about promising effect in delivery service utilization.
Organization:
KIT - Royal Tropical Institute
,
VU - Vrije Universiteit Amsterdam
Institute:
KIT (Royal Tropical Institute)
Department:
Development, Policy and Practice
Country:
Bhutan
Region:
South Asia
Training:
Master of Public Health / International Course in Health Development (MPH/ICHD)
Category:
Research
Right:
© 2015 Karki
Document type:
Thesis/dissertation
File:
0Nb81isuch_20161025122444153.pdf