Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jun 8;13 Suppl 1(Suppl 1):34.
doi: 10.1186/s12978-016-0140-1.

Health care seeking behaviours in pregnancy in rural Sindh, Pakistan: a qualitative study

Rahat Najam Qureshi  1 , Sana Sheikh  2 , Asif Raza Khowaja  2   3 , Zahra Hoodbhoy  2 , Shujaat Zaidi  2 , Diane Sawchuck  3 , Marianne Vidler  3 , Zulfiqar A Bhutta  2   4 , Peter von Dadeslzen  3 ; CLIP Working Group
Affiliations

Health care seeking behaviours in pregnancy in rural Sindh, Pakistan: a qualitative study

Rahat Najam Qureshi et al. Reprod Health. .

Abstract

Background: Pakistan has alarmingly high numbers of maternal mortality along with suboptimal care-seeking behaviour. It is essential to identify the barriers and facilitators that women and families encounter, when deciding to seek maternal care services. This study aimed to understand health-seeking patterns of pregnant women in rural Sindh, Pakistan.

Methods: A qualitative study was undertaken in rural Sindh, Pakistan as part of a large multi-country study in 2012. Thirty three focus group discussions and 26 in-depth interviews were conducted with mothers [n = 173], male decision-makers [n = 64], Lady Health Workers [n = 64], Lady Health Supervisors [n = 10], Women Medical Officers [n = 9] and Traditional Birth Attendants [n = 7] in the study communities. A set of a priori themes regarding care-seeking during pregnancy and its complications as well as additional themes as they emerged from the data were used for analysis. Qualitative analysis was done using NVivo version 10.

Results: Women stated they usually visited health facilities if they experienced pregnancy complications or danger signs, such as heavy bleeding or headache. Findings revealed the importance of husbands and mothers-in-law as decision makers regarding health care utilization. Participants expressed that poor availability of transport, financial constraints and the unavailability of chaperones were important barriers to seeking care. In addition, private facilities were often preferred due to the perceived superior quality of services.

Conclusion: Maternal care utilization was influenced by social, economic and cultural factors in rural Pakistani communities. The perceived poor quality care at public hospitals was a significant barrier for many women in accessing health services. If maternal lives are to be saved, policy makers need to develop processes to overcome these barriers and ensure easily accessible high-quality care for women in rural communities.

Trial registration: NCT01911494.

Keywords: Antenatal care; Associated factors; Health facilities; Health seeking behaviour; Pakistan; Patient acceptance of health care; Pregnancy; Pregnancy complications.

PubMed Disclaimer

References

    1. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995;36(1):1–10. doi: 10.2307/2137284. - DOI - PubMed
    1. Mackian S, Bedri N, Lovel H. Up the garden path and over the edge: where might health-seeking behaviour take us? Health Policy Plan. 2004;19(3):137–46. doi: 10.1093/heapol/czh017. - DOI - PubMed
    1. Suchman EA. Stages of illness and medical care. J Health Hum Behav. 1965;6(3):114–28. doi: 10.2307/2948694. - DOI - PubMed
    1. Jafarey SN, Korejo R. Mothers brought dead: an enquiry into causes of delay. Soc Sci Med. 1993;36(3):371–2. doi: 10.1016/0277-9536(93)90021-U. - DOI - PubMed
    1. Bloom SS, Wypij D, Gupta MD. Dimensions of women's autonomy and the influence on maternal health care utilization in a north Indian city. Demography. 2001;38(1):67–78. doi: 10.1353/dem.2001.0001. - DOI - PubMed

Associated data