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Barriers to Skilled Birth Attendance: A Survey among Mothers in Rural Gambia

Priya Miriam Lerberg et al. Barriers to Skilled Birth Attendance: A Survey among Mothers in Rural Gambia. Afr J Reprod Health 2014; 18[1]: 35-43
Abstract / Summary: 
ABSTRACT The objectives of this cross-sectional survey were to identify the most important barriers for use of skilled attendance during childbirth by women in rural Gambia. We also assessed information received during antenatal care, preparations made prior to childbirth, and experiences and perceptions that may influence the use of skilled birth attendance in rural Gambia. The most frequently stated barriers for giving birth in a health facility were not having enough time to go (75%), and lack of transport (29%). The majority of the women (83%) stated that they preferred having a health worker attending their childbirth. More than seventy percent of the participants gave birth attended by a traditional birth attendant, but only 27% had intended to give birth at home. Sixty-four percent had made advance arrangements for the childbirth. Only 22% were informed about expected time of birth during antenatal care. Our findings suggest that the participants hold the knowledge and motivation that is necessary if practices are to be changed. Interventions aiming at ensuring timely transport of women to health facilities seem key to increased use of skilled birth attendants. (Afr J Reprod Health 2014; 18[1]: 35-43).  
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Selected extracts: 
'Villages with more than 400 inhabitants have resident TBAs that have received government-supported training'
'Three out of four respondents reported that they were assisted by a TBA during childbirth. Eighty three percent said they would have preferred being assisted by someone else than the person who had assisted them, and most would have wanted a health professional. Four out of five mentioned skills and access to drugs as important reasons for wanting a health professional present during childbirth. Health personnel's ability to handle complications was emphasised by two out of three respondents.'
'Practically all (99%) agreed when asked if doctors and nurses are knowledgeable about the care a woman need, and 97% agreed that TBAs are.'
'We asked the participants if they thought nurses/doctors/TBAs know what to do in case of complications: 99.5% agreed that doctors know what to do, 99% agreed that nurses know, and only three percent thought that the TBAs know what to do.'
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Priya Miriam Lerberg et al.  
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