Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #117072

Pamela L. Bolton, MHS, Francophone Africa Program, Family Care International, 588 Broadway, Suite 503, New York, NY 10012, (212) 941-5300, pbolton@familycareintl.org, Ann K. Blanc, PhD, Blancroft Research International, 11718 Lightfall Court, Columbia, MD 21044, and Ellen Brazier, MA, Anglophone Africa Program, Family Care International, 508 Broadway, Suite 503, New York, NY 10025.

Evidence has shown that the single most effective way to prevent maternal deaths is to ensure that women give birth with a skilled health professional. Yet in poor communities, significant barriers to care exist.

We fielded a large-scale household survey in 2003, interviewing representative samples of roughly 5,000 women of reproductive age and 2,600 co-resident male partners in three countries. (Total n =22,761).

Most respondents are aware that any woman can develop serious health problems in pregnancy and childbirth, and believe professional assistance is safer than delivery with a traditional provider. However, skilled care rates for births over the previous two years were 25%-44%. A number of barriers to care-seeking were revealed: in Burkina Faso and Tanzania 40-50% of respondents could not name any “danger sign” in pregnancy. Though most agreed women should plan for births, we found relatively little evidence that families make such plans; many voiced the seemingly contradictory belief that little or nothing could be done to avert a poor pregnancy outcome. Women in Burkina Faso are least likely to have discussed where the baby would be delivered (about one-third), or to have put money aside to pay for delivery (one-fifth). Confidence in health services may be another barrier: fewer than half of respondents in Burkina, and about two-thirds in Kenya and Tanzania, believed that staff at their nearest health facility were able treat serious complications; even fewer (a third to a half) believed that the health facilities were properly equipped and supplied to treat delivery problems.

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