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Lived Experiences and Perceptions of Childbirth among Pastoralist Women in North-East Ethiopia: A Multimethod Qualitative Analysis to the WHO Health Systems Responsiveness Framework

Zepro, Nejimu Biza and Medhanyie, Araya Abrha and Bezabih, Afework Mulugeta and Tarr, Natalie and Merten, Sonja. (2021) Lived Experiences and Perceptions of Childbirth among Pastoralist Women in North-East Ethiopia: A Multimethod Qualitative Analysis to the WHO Health Systems Responsiveness Framework. International Journal of Environmental Research and Public Health, 18 (23). p. 12518.

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Abstract

Maternity should be a time of hope and joy. However, for women in pastoralist communities in Ethiopia, the reality of motherhood is often grim. This problem is creating striking disparities of skilled birth uptake among the agrarian and pastoral communities in Ethiopia. So far, the depth and effects of the problem are not well understood. This study is intended to fill this research gap by exploring mothers' lived experiences and perceptions during skilled birthing care in hard- to-reach communities of Ethiopia. An Interpretive Phenomenological approach was employed to analyse the exploratory data. Four key informant interviews, six in-depth interviews, six focus group discussions, and twelve focused observations were held. WHO responsiveness domains formed the basis for coding and analysis: dignity, autonomy, choice of provider, prompt attention, communication, social support, confidentiality, and quality of basic amenities. The skilled birthing experience of nomadic mothers is permeated by a deep-rooted and hidden perceived neglect, which constitutes serious challenges to the health system. Mothers' experiences reflect not only the poor skilled delivery uptake, but also how health system practitioners are ignorant of Afar women's way of life, their living contexts, and their values and beliefs regarding giving birth. Three major themes emerged from data analysis: bad staff attitude, lack of culturally acceptable care, and absence of social support. Nomadic mothers require health systems that are responsive and adaptable to their needs, beliefs, and values. The abuse and disrespect they experience from providers deter nomadic women from seeking skilled birthing care. Women's right to dignified, respectful, skilled delivery care requires the promotion of woman-centred care in a culturally appropriate manner. Skilled birthing care providers should be cognizant of the WHO responsiveness domains to ensure the provision of culturally sensitive birthing care.
Faculties and Departments:04 Faculty of Humanities and Social Sciences
08 Cross-disciplinary Subjects
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Society, Gender and Health > Gender and Inequities (Merten)
UniBasel Contributors:Tarr, Natalie and Merten, Sonja and Zepro, Nejimu
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:MDPI
e-ISSN:1660-4601
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
Identification Number:
edoc DOI:
Last Modified:17 Oct 2023 10:12
Deposited On:15 Dec 2021 16:16

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