Perceptions of prenatal and obstetric care in Sub-Saharan Africa

Abstract

Background: The maternal mortality ratio in Sub-Saharan Africa remains high, despite progress in reducing maternal mortality in other parts of the world.

Objective: To explore the perceptions of women and communities to identify barriers to the uptake of obstetric services.

Search strategy: A systematic review of qualitative studies exploring perceptions of pregnancy and obstetric services, with thematic synthesis of the included studies.

Selection criteria: Qualitative studies reporting findings from focus group discussions and in-depth interviews between 1996 and 2009 were included.

Data collection and analysis: Thematic synthesis involved collating and reviewing quotations taken directly from included studies. Themes were generated and clustered for analysis.

Main results: Twenty-seven studies were included and 6 major themes identified: perceptions of healthcare workers; perceptions of the hospital environment; cultural perceptions of women; cultural perceptions of pregnancy; perceptions of traditional birth attendants and traditional healers; and role of the community in pregnancy and birth.

Conclusion: Community attitudes regarding cultural beliefs and interactions with healthcare providers were identified as barriers to the utilization of healthcare services during pregnancy in Sub-Saharan Africa. These prevent engagement with prenatal care and timely use of medical services. Addressing the barriers will be seminal to the success of any healthcare intervention.