Focus group discussions on the perceived benefits of and barriers for the use of modern effective perinatal care practices in Georgia

Improving maternal and child health (MCH) is a key priority of the Georgian Government. Since 2006, two JSI projects (funded by USAID) have been implementing the WHO recommended Effective Perinatal Care (EPC) practices in maternity hospitals throughout the country. In 2012, a national communication campaign was launched to promote modern evidence-based maternity care. The key MCH messages conveyed to target audiences were developed based on focus group discussions. Six focus groups were conducted with doctors (obstetricians/gynecologists and neonatologists), midwives and nurses from different maternity clinics at central and regional levels. The focus group results showed that the main perceived advantages of the new practices for women and couples were: family friendly environment in maternity ward, companion presence and support during labor and delivery, elimination of unnecessary interventions including shaving and enema, free positions during delivery, mother and child togetherness and skin-to-skin contact immediately after birth, early breastfeeding, less complications, early discharge and reduced expenses. Among the perceived disadvantages, almost all participants reported common misconception that less interventions means poor quality of care. In rare cases, women were annoyed by the fact that their babies were not taken away after birth allowing them to have a “baby break” and rest. The lack of information and geographic access were cited to be the main barriers for using modern MCH services. The outcomes of the communication campaign need to be evaluated further to be better understood in order to continue to expand access to evidence-based and cost-effective maternity care nationwide.