Roger W. Rochat, MD, Department of International Health, Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30322, 404 712 9506, rrochat@sph.emory.edu and Gurkiran K. Sardar, BA, MPH, Rollins School of Public Health, Emory University, 1518 Clifton Road, N.E., Atlanta, GA 30307.

The leading cause of death and disability amongst women of reproductive age in developing countries is complications from pregnancy. In Africa, Rwanda has one of the highest maternal mortality rates at 1,071 per 100,000. More than a third of all deliveries occur at home, and 50-60% of these are attended by untrained traditional birth attendants. Approximately 20-30% of all births are assisted by a relative or alone. Since 2000, the Rwandan Ministry of Health has been working with CARE Rwanda’s Project FEMME (Foundation to Enhance the Management of Maternal Emergencies) to increase the use of quality maternal health services while reducing the case fatality rates in hospitals in the Gitarama Province. Evaluation by CARE indicated that utilization patterns at two of the three district hospitals (Gitwe and Kabgayi) in Gitarama were very different, even though the same interventions were provided at both facilities. Over a seven-week period, semi-structured interviews at the community, health center and hospital level were conducted to better understand maternal health service utilization patterns in Kabgayi and Gitwe districts. Semi-structured interviews were conducted with 19 pregnant women and mothers, 24 health workers and birth attendants, and 11 community members in each region. Data analysis revealed that despite poverty and poor access to care, women did have adequate knowledge of danger signs during pregnancy and when to seek help. Moreover, pregnancy status, relationships with men, and community networks played significant roles in women’s decision-making process.

Learning Objectives:

• Demonstrate a deeper understanding of the low utilization of maternal health services in the districts of Gitwe and Kabgayi in the Gitarama Province of Rwanda.
• Identify major factors influencing women’s decision-making process.
• Articulate the benefits and challenges of qualitative research methods to this field of study.
• Discuss suggestions and recommendations for improving maternal health service utilization.

Keywords: Care Seeking, Health Care Utilization

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.