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CABI Book Chapter

Maternal and perinatal health in developing countries.

Book cover for Maternal and perinatal health in developing countries.

Description

The promotion of maternal health and mortality reduction is of worldwide importance, and constitutes a vital part of the UN Millennium Development Goals. The highest maternal mortality rates are in developing countries, where global and regional initiatives are needed to improve the systems and practices involved in maternal care and medical access. Taking a practical policy approach, this book co...

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Chapter 12 (Page no: 155)

Demand for maternity care: beliefs, behaviour and social access.

Demand side interventions are necessary to increase use of maternity services. Factors that affect demand include knowledge of danger signs in pregnancy and childbirth; financial, geographical and social access to health care; quality of care and the gendered norms and values around maternal health-seeking behaviours. Three key concepts related to influencing the demand for care during pregnancy and childbirth are discussed in detail: providing culturally sensitive contextual knowledge; how health systems create social barriers to uptake of services; and the overarching influence of gender. Empowering people by providing culturally contextual knowledge that does not devalue local beliefs and practices is crucial to improve the acceptability of biomedical services. Communication and education approaches that focus on eliciting a dialogue between traditional understandings of health and biomedical priorities may produce a greater demand for services than the traditional unidirectional 'transmission-persuasion' approach. Societal values and norms are signalled and reinforced by the health system. The commonly reported neglect, abuse and exclusion within health-care systems may be a reflection of the experience of being poor and socially marginalized in that society. There are few published interventions aimed at reducing social barriers to health services. Existing initiatives include improving health worker attitudes and using rights based frameworks to develop client centred non-discriminatory service delivery systems. Aspects of the gender order that affect demand for maternity care include women's social and economic dependency on men, limited decision-making authority and restricted access to financial and material resources. For women living in unequal gender contexts, policies to create social change at the group level may be needed, rather than focusing on women's individual-level bargaining power.

Other chapters from this book

Chapter: 1 (Page no: 1) An introduction to maternal and perinatal health. Author(s): Hussein, J. Blanc, A. K. Donnay, F. McCaw-Binns, A.
Chapter: 2 (Page no: 10) The Millennium Development Goals. Author(s): McCaw-Binns, A. Hussein, J.
Chapter: 3 (Page no: 25) The politics of progress: the story of maternal mortality. Author(s): Graham, W. J.
Chapter: 4 (Page no: 40) The epidemiology of maternal mortality. Author(s): Stanton, C. McCaw-Binns, A.
Chapter: 5 (Page no: 51) The epidemiology of stillbirths and neonatal deaths. Author(s): Stanton, C. Lawn, J. E.
Chapter: 6 (Page no: 64) Health systems. Author(s): Mavalankar, D. V. Raman, P. S.
Chapter: 7 (Page no: 77) Financing maternity care. Author(s): Witter, S. Ensor, T.
Chapter: 8 (Page no: 96) Implementing clinical interventions within maternal health programmes. Author(s): Langer, A. Knight, H. Charnock, A. Wegner, M. N. Villar, J.
Chapter: 9 (Page no: 114) Medical conditions in pregnancy. Author(s): Webber, R. McCaw-Binns, A. Hussein, J.
Chapter: 10 (Page no: 127) Improving the availability of services. Author(s): Phoya, A. Mavalankar, D. V. Raman, P. S. Hussein, J.
Chapter: 11 (Page no: 139) Geographical access, transport and referral systems. Author(s): Munjanja, S. P. Magure, T. Kandawasvika, G.
Chapter: 13 (Page no: 170) Empowering the community: BRAC's approach in Bangladesh. Author(s): Kaosar Afsana
Chapter: 14 (Page no: 181) Quality of care. Author(s): Achadi, E. Pitchforth, E. Hussein, J.
Chapter: 15 (Page no: 193) Monitoring and evaluation. Author(s): Hounton, S. Newlands, D. Meda, N. Hussein, J.
Chapter: 16 (Page no: 210) Addressing maternal health in emergency settings. Author(s): Bartlett, L. Aitken, I. Smith, J. M. Thomas, L. J. Rosen, H. E. Tappis, H. Burnham, G.