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Determining factors and utilization pattern for normal delivery care in Nangarhar province of Afghanistan

Document type: mthesis
Download file(s): 455716 (1007 KB)
Abstract: BACKGROUND: Skilled birth attendance in Afghanistan’s Nangarhar Province is only 20%. Of these 20%, normal deliveries take predominantly place in hospitals rather than in lower level health care facilities. OBJECTIVES AND METHODS: To describe and analyse factors related to skilled birth attendance and to the pattern of services utilization regarding normal delivery care in the province. These factors were explored by a review of unpublished literature and HMIS data from Nangarhar, national surveys and experience from other counties. FINDINGS: Very low coverage of antenatal care (38.6%), health facilities without female staff (18% - 42%) and shortage of female doctors in 47% of health facilities. The quality of care is perceived as low. About 41% women believe that it is not important to deliver in health facilities. Deliveries cost 17.5 US$ and 31.7 US$ to the patient in health centres and hospitals respectively. Of the 20% of skilled birth attendance, 14.6 % takes place in hospitals, 1.6% in lower level public health facilities and the rest in private facilities. There is no functional referral system in the province to filter patients and ensure access of care during emergency needs. CONCLUSION: women in Nangarhar do not deliver in health facilities and, if they do, they prefer hospitals. Several factors play a key role and need to be addressed. This includes improving the knowledge of women about the importance of ANC, addressing the gaps in human resources, and developing health care financing models for delivery care. Furthermore there is a need for strong referral and “gate keeping”, to keep the patient at the right level of care and avoid self referral, and to review hospital funding.
Authors: Naseem, M.
Country: Afghanistan
Category: Research
Department: Development, Policy and Practice
Institute: KIT - Royal Tropical Institute
Keywords: health services , maternal and child health , reproductive health , women
Language: eng
Organization: KIT - Royal Tropical Institute
Organization: VU - Vrije Universiteit Amsterdam
PAGE: viii, 37, xiii
Place: Amsterdam
Publisher: KIT - Royal Tropical Institute [etc.]
Year: 2012
Region: Southwest Asia
Right: © 2012 Naseem
Subject: Health and Nutrition
Title: Determining factors and utilization pattern for normal delivery care in Nangarhar province of Afghanistan
Training: Master of Public Health