Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study
Abstract Background Indonesia’s progress on reducing maternal and newborn mortality rates has slowed in recent years, predominantly in rural areas. To reduce maternal and newborn mortality, access to quality and skilled care, particularly at the facility level, is crucial. Yet, accessing such care i...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | Journal of Health, Population and Nutrition |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41043-017-0122-0 |
| _version_ | 1819261695560777728 |
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| author | Alfonso Rosales Sigit Sulistyo Oktarinda Miko Lila K. Hairani Meita Ilyana Joanne Thomas Emily Hirata Rhonda Holloway Michael Bantung Kristina Pabate Candra Wijaya Dennis Cherian |
| author_facet | Alfonso Rosales Sigit Sulistyo Oktarinda Miko Lila K. Hairani Meita Ilyana Joanne Thomas Emily Hirata Rhonda Holloway Michael Bantung Kristina Pabate Candra Wijaya Dennis Cherian |
| author_sort | Alfonso Rosales |
| collection | DOAJ |
| description | Abstract Background Indonesia’s progress on reducing maternal and newborn mortality rates has slowed in recent years, predominantly in rural areas. To reduce maternal and newborn mortality, access to quality and skilled care, particularly at the facility level, is crucial. Yet, accessing such care is often delayed when maternal and newborn complications arise. Using the “Three Delays” model originated by Thaddeus and Maine (1994), investigation into reasons for delaying the decision to seek care, delaying arrival at a health facility, and delaying the receiving of adequate care, may help in establishing more focused interventions to improve maternal and newborn health in this region. Methods This qualitative study focused on identifying, analyzing, and describing illness recognition and care-seeking patterns related to maternal and newborn complications in the Jayawijaya district of Papua province, Indonesia. Group interviews were conducted with families and other caregivers from within 15 villages of Jayawijaya who had either experienced a maternal or newborn illness or maternal or newborn death. Results For maternal cases, excessive bleeding after delivery was recognized as a danger sign, and the process to decide to seek care was relatively quick. The decision-making process was mostly dominated by the husband. Most care was started at home by birth attendants, but the majority sought care outside of the home within the public health system. For newborn cases, most of the caregivers could not easily recognize newborn danger signs. Parents acted as the main decision-makers for seeking care. Decisions to seek care from a facility, such as the clinic or hospital, were only made when healthcare workers could not handle the case within the home. All newborn deaths were associated with delays in seeking care due to caretaker limitations in danger sign identification, whereas all maternal deaths were associated with delays in receiving appropriate care at facility level. Conclusions For maternal health, emphasis needs to be placed on supply side solutions, and for newborn health, emphasis needs to be placed on demand and supply side solutions, probably including community-based interventions. Contextualized information for the design of programs aimed to affect maternal and newborn health is a prerequisite. |
| first_indexed | 2024-12-23T19:45:53Z |
| format | Article |
| id | doaj.art-1baf69b45e724c7791d1e9bd7db60d38 |
| institution | Directory Open Access Journal |
| issn | 2072-1315 |
| language | English |
| last_indexed | 2024-12-23T19:45:53Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Health, Population and Nutrition |
| spelling | doaj.art-1baf69b45e724c7791d1e9bd7db60d382022-12-21T17:33:32ZengBMCJournal of Health, Population and Nutrition2072-13152017-12-0136S1354410.1186/s41043-017-0122-0Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative studyAlfonso Rosales0Sigit Sulistyo1Oktarinda Miko2Lila K. Hairani3Meita Ilyana4Joanne Thomas5Emily Hirata6Rhonda Holloway7Michael Bantung8Kristina Pabate9Candra Wijaya10Dennis Cherian11Department of Health, World Vision USWorld Vision IndonesiaCenter of Epidemiology Research and Surveillance, University of Indonesia (CERS UI), Faculty of Public Health, University of IndonesiaCenter of Epidemiology Research and Surveillance, University of Indonesia (CERS UI), Faculty of Public Health, University of IndonesiaCenter of Epidemiology Research and Surveillance, University of Indonesia (CERS UI), Faculty of Public Health, University of IndonesiaDepartment of Health, World Vision USDepartment of Health, World Vision USDepartment of Health, World Vision USWorld Vision IndonesiaWorld Vision IndonesiaWorld Vision IndonesiaDepartment of Health, World Vision USAbstract Background Indonesia’s progress on reducing maternal and newborn mortality rates has slowed in recent years, predominantly in rural areas. To reduce maternal and newborn mortality, access to quality and skilled care, particularly at the facility level, is crucial. Yet, accessing such care is often delayed when maternal and newborn complications arise. Using the “Three Delays” model originated by Thaddeus and Maine (1994), investigation into reasons for delaying the decision to seek care, delaying arrival at a health facility, and delaying the receiving of adequate care, may help in establishing more focused interventions to improve maternal and newborn health in this region. Methods This qualitative study focused on identifying, analyzing, and describing illness recognition and care-seeking patterns related to maternal and newborn complications in the Jayawijaya district of Papua province, Indonesia. Group interviews were conducted with families and other caregivers from within 15 villages of Jayawijaya who had either experienced a maternal or newborn illness or maternal or newborn death. Results For maternal cases, excessive bleeding after delivery was recognized as a danger sign, and the process to decide to seek care was relatively quick. The decision-making process was mostly dominated by the husband. Most care was started at home by birth attendants, but the majority sought care outside of the home within the public health system. For newborn cases, most of the caregivers could not easily recognize newborn danger signs. Parents acted as the main decision-makers for seeking care. Decisions to seek care from a facility, such as the clinic or hospital, were only made when healthcare workers could not handle the case within the home. All newborn deaths were associated with delays in seeking care due to caretaker limitations in danger sign identification, whereas all maternal deaths were associated with delays in receiving appropriate care at facility level. Conclusions For maternal health, emphasis needs to be placed on supply side solutions, and for newborn health, emphasis needs to be placed on demand and supply side solutions, probably including community-based interventions. Contextualized information for the design of programs aimed to affect maternal and newborn health is a prerequisite.http://link.springer.com/article/10.1186/s41043-017-0122-0Maternal and newborn mortalityIndonesiaQualitative studyIllness recognitionCare-seekingMaternal health |
| spellingShingle | Alfonso Rosales Sigit Sulistyo Oktarinda Miko Lila K. Hairani Meita Ilyana Joanne Thomas Emily Hirata Rhonda Holloway Michael Bantung Kristina Pabate Candra Wijaya Dennis Cherian Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study Journal of Health, Population and Nutrition Maternal and newborn mortality Indonesia Qualitative study Illness recognition Care-seeking Maternal health |
| title | Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study |
| title_full | Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study |
| title_fullStr | Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study |
| title_full_unstemmed | Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study |
| title_short | Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study |
| title_sort | recognition of and care seeking for maternal and newborn complications in jayawijaya district papua province indonesia a qualitative study |
| topic | Maternal and newborn mortality Indonesia Qualitative study Illness recognition Care-seeking Maternal health |
| url | http://link.springer.com/article/10.1186/s41043-017-0122-0 |
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