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Tytuł pozycji:

Understanding pathways leading to stillbirth: The role of care-seeking and care received during pregnancy and childbirth in Kabul province, Afghanistan.

Tytuł:
Understanding pathways leading to stillbirth: The role of care-seeking and care received during pregnancy and childbirth in Kabul province, Afghanistan.
Autorzy:
Christou A; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia. Electronic address: .
Alam A; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Sadat Hofiani SM; Afghanistan National Public Health Institute, Ministry of Public Health, Kabul, Afghanistan.
Rasooly MH; Afghanistan National Public Health Institute, Ministry of Public Health, Kabul, Afghanistan.
Mubasher A; World Health Organization, Kabul, Afghanistan.
Rashidi MK; Management Sciences for Health, Kabul, Afghanistan.
Dibley MJ; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Raynes-Greenow C; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Źródło:
Women and birth : journal of the Australian College of Midwives [Women Birth] 2020 Nov; Vol. 33 (6), pp. 544-555. Date of Electronic Publication: 2020 Feb 21.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Original Publication: Amsterdam ; New York : Elsevier, c2006-
MeSH Terms:
Quality of Health Care*
Stillbirth*
Delivery, Obstetric/*statistics & numerical data
Fetal Death/*prevention & control
Health Services Accessibility/*statistics & numerical data
Perinatal Care/*statistics & numerical data
Adult ; Afghanistan ; Aged ; Child ; Female ; Health Personnel ; Humans ; Infant, Newborn ; Interviews as Topic ; Parturition ; Patient Acceptance of Health Care ; Pregnancy ; Qualitative Research ; Risk Factors ; Urban Population
Grant Information:
001 International WHO_ World Health Organization
Contributed Indexing:
Keywords: Afghanistan; Care-Seeking; Fetal death; Health services access; Health system; Perinatal death; Quality of care; Stillbirth
Entry Date(s):
Date Created: 20200226 Date Completed: 20201222 Latest Revision: 20210110
Update Code:
20240105
DOI:
10.1016/j.wombi.2020.02.012
PMID:
32094034
Czasopismo naukowe
Background: The underlying pathways leading to stillbirth in low- and middle-income countries are not well understood. Context-specific understanding of how and why stillbirths occur is needed to prioritise interventions and identify barriers to their effective implementation and uptake.
Aim: To explore the contribution of contextual, individual, household-level and health system factors to stillbirth in Afghanistan.
Methods: Using a qualitative approach, we conducted semi-structured in-depth interviews with women and men that experienced stillbirth, female elders, community health workers, healthcare providers, and government officials in Kabul province, Afghanistan between October-November 2017. We used thematic analysis to identify contributing factors and developed a conceptual map describing possible pathways to stillbirth.
Findings: We found that low utilisation and access to healthcare was a key contributing factor, as were unmanaged conditions in pregnancy that increased women's risk of complications and stillbirth. Sociocultural factors related to the treatment of women and perceptions about medical interventions deprived women of interventions that could potentially prevent stillbirth. The quality of care from public and private providers during pregnancy and childbirth was a recurring concern exacerbated by health system constraints that led to unnecessary delays; while environmental factors linked to the ongoing conflict were also perceived to contribute to stillbirth. These pathways were underscored by social, cultural, economic factors and individual perceptions that contributed to the three-delays.
Discussion: Efforts are needed at the community-level to facilitate care-seeking and raise awareness of stillbirth risk factors and the facility-level to strengthen antenatal and childbirth care quality, ensure culturally appropriate and respectful care, and reduce treatment delays.
(Copyright © 2020 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.)

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