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
. 2022 Apr 2;22(1):278.
doi: 10.1186/s12884-022-04609-y.

Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia

Meselech Assegid Roro  1 , Abebech Demissie Aredo  1 , Tesfaye Kebede  2 , Abiy Seifu Estifanos  3
Affiliations

Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia

Meselech Assegid Roro et al. BMC Pregnancy Childbirth. .

Abstract

Background: The World Health Organization (WHO) recommends a minimum of eight ANC contacts during pregnancy, of which having one ultrasound examination before 24 weeks of gestation is indicated. Ultrasound plays a significant role in the surveillance and management of high-risk pregnancies. However, the obstetric ultrasound coverage in resource limited settings remains low. Evidence examining the barriers and facilitators to obstetrics ultrasound use in a resource-limited setting like Ethiopia is lacking. This qualitative study explored the facilitators and barriers to introducing obstetric Vscan Access ultrasound in primary health care facilities in Ethiopia.

Methods: The study employed a qualitative descriptive exploratory study design using in-depth interviews (IDIs) and focus group discussions (FGDs). The study participant were mothers who have had recent birth, community members, maternal and newborn service providers, and their managers. We employed an inductive thematic analysis to analyze the data.

Result: We conducted a total of ten FGDs, three with community members and seven with maternal and newborn service providers, and 52 IDIs with the service providers and health facility managers. Two major themes, health system related and client-related factors, emerged from the analysis. The health system related enablers include increased knowledge and skill of the providers, improved mothers and providers' motivation, increased service utilization, and improved quality of maternal and newborn care (MNC), and enhanced referral system. The health system related barriers include service interruption, staff shortage/workload, and the providers' limited capacity. Under the main theme of client-related factors, barriers include perceived limited knowledge and skills of providers and the small size of the ultrasound machine while the facilitators include mothers' needs and interest in ultrasound scan, availability of free of charge ultrasound service, and increased demand for ultrasound scan service.

Conclusion: Our data suggest that the health system provides an enabling context to introduce limited obstetric ultrasound service and routinely provide the service through mid-level maternal care providers at primary health care level in resource limited settings. Overcoming the health system and client related barriers will maximize and sustain the use of the technology.

Keywords: Barriers; Enablers; Limited obstetrics ultrasound; Qualitative; Vscan ultrasound.

PubMed Disclaimer

Conflict of interest statement

The author declared that they have no competing interests.

Figures

Fig. 1
Fig. 1
Enablers and barriers to introduction of obstetric ultrasound service at primary health care facilities, Ethiopia
See this image and copyright information in PMC

References

    1. Kruse C, Betancourt J, Ortiz S, Luna SMV, Bamrah IK, Segovia N. Barriers to the use of mobile health in improving health outcomes in developing countries: systematic review. J Med Internet Res. 2019;21(10):e13263. doi: 10.2196/13263. - DOI - PMC - PubMed
    1. Lawn J, Kerber K. Opportunities for Africa’s newborns: practical data, policy and programmatic support for newborn care in Africa. Cape Town: Partnership for Maternal, Newborn and Child Health; 2006. p. 32.
    1. Tunçalp Ӧ, Pena-Rosas JP, Lawrie T, Bucagu M, Oladapo OT, Portela A, et al. WHO recommendations on antenatal care for a positive pregnancy experience-going beyond survival. Bjog. 2017;124(6):860–862. doi: 10.1111/1471-0528.14599. - DOI - PubMed
    1. Holmlund S, Ntaganira J, Edvardsson K, Lan PT, Semasaka Sengoma JP, Åhman A, et al. Improved maternity care if midwives learn to perform ultrasound: a qualitative study of Rwandan midwives’ experiences and views of obstetric ultrasound. Glob Health Action. 2017;10(1):1350451. doi: 10.1080/16549716.2017.1350451. - DOI - PMC - PubMed
    1. de Masi S, Bucagu M, Tunçalp Ö, Peña-Rosas JP, Lawrie T, Oladapo OT, et al. Integrated person-centered health care for all women during pregnancy: implementing World Health Organization recommendations on antenatal care for a positive pregnancy experience. Glob Health Sci Pract. 2017;5(2):197–201. doi: 10.9745/GHSP-D-17-00141. - DOI - PMC - PubMed

LinkOut - more resources