The perceptions of women on child birthing in a public-health facility in a peri-urban area in Kavango east region, Namibia

Abstract

Purpose: The study explored the perceptions of women on child birthing in a public-health facility in a peri-urban area of the Kavango east region. Methods: A qualitative case study was conducted with women residing in Kehemu settlement, who have given birth either using a public-health facility or outside a public facility with the assistance of traditional birth attendants. Data were collected via three focus group discussions with 21 women (n = 21) who were purposively selected. Discussions were conducted in a local language and all were audio recorded with the participants' permission. Data were transcribed and translated into English for analysis. The process of data reduction was used to analyse the study data. Results: Women were found to prefer child birthing at a public hospital because they considered nurses and midwives to be knowledgeable, caring and skilled people with regard to managing a woman in labour. However, although some women prefer to deliver at a public hospital, circumstances such as lack of transport -especially at night-time -prevent them from reaching the hospital. Moreover, some women indicated that nurses' attitudes, the ill timing of labour and the wrong advice were hindrances to public hospital child birthing. Women stated more nurses, more supplies of the items used in child birthing, the provision of pain relief during labour, and a change in nurses' attitudes as being some of the improvements which would make public hospital maternity wards more user-friendly. Conclusions: The women perceived child birthing at the public-health facility as being generally good, affordable and acceptable. However, there is a need for more interventions to make the public-health facility more user-friendly and accessible to all.

Experiences of Health Facility Childbirth in Sub-Saharan Africa: A Systematic Review of Qualitative Evidence

“…Following removal of duplicates, 5,301 results remained, from which 70 records were retained, after title and abstract screening. Following full-text assessment, 22 (21 qualitative quality Adinew & Assefa, 2017 ; Afulani et al, 2017 ; Balde et al, 2017 ; Bohren et al, 2016 , 2017 ; D’Ambruoso et al, 2005 ; Dzomeku et al, 2017 ; Kumbani et al, 2012 ; Madula et al, 2018 ; Maputle & Nolte, 2008 ; Maya et al, 2018 ; McMahon et al, 2014 ; Mensah et al, 2014 ; Mukamurigo et al, 2017 ; Muntenda et al, 2017 ; Namujju et al, 2018 ; Ojelade et al, 2017 ; Okonofua et al, 2017a , b ; Okwako & Symon, 2014 ; Orpin et al, 2018 ; Shimpuku et al, 2013 ) and one mixed (Nwosu et al, 2012 ) studies met the inclusion criteria (Fig. 2 ).…”

“…Of the 22 studies, fifteen were adjudged as high-quality (Adinew & Assefa, 2017 ; Afulani et al, 2017 ; Balde et al, 2017 ; Bohren et al, 2016 , 2017 ; Dzomeku et al, 2017 ; Kumbani et al, 2012 ; Maya et al, 2018 ; McMahon et al, 2014 ; Mukamurigo et al, 2017 ; Muntenda et al, 2017 ; Namujju et al, 2018 ; Ojelade et al, 2017 ; Okwako & Symon, 2014 ; Orpin et al, 2018 ), six as moderate quality (D’Ambruoso et al, 2005 ; Madula et al, 2018 ; Maputle & Nolte, 2008 ; Mensah et al, 2014 ; Okonofua, et al, 2017a , b ; Shimpuku et al, 2013 ) and one low-quality (Nwosu et al, 2012 ) (Table 1 and Supplementary file 1).…”

“…The commonest form of verbal abuse reported was speaking to women in raised voices, with some women stating that SHP outrightly hurled abusive and demeaning words at them (Adinew & Assefa, 2017 ; D’Ambruoso et al, 2005 ; Kumbani et al, 2012 ; Madula et al, 2018 ; Maya et al, 2018 ; Muntenda et al, 2017 ; Namujju et al, 2018 ). Physical abuse such as slapping, pinching, or hitting on the thighs were also detailed in accounts of negative experiences from all three SSA regions (Bohren et al, 2017 ; McMahon et al, 2014 ; Muntenda et al, 2017 ; Namujju et al, 2018 ; Orpin et al, 2018 ).…”

“…Included studies from West Africa were conducted in Nigeria (Bohren et al, 2016(Bohren et al, , 2017Nwosu et al, 2012;Okonofua et al, 2017a, b;Orpin et al, 2018), Ghana (D'Ambruoso et al, 2005;Dzomeku et al, 2017;Maya et al, 2018;Mensah et al, 2014), and Guinea (Balde et al, 2017). While studies from Southern Africa were from South Africa (Maputle & Nolte, 2008) and Namibia (Muntenda et al, 2017) (Fig. 4).…”

“…Only one study, conducted in Uganda, reported that women were allowed their chosen companion during labour (Namujju et al, 2018). The other studies reported unmet need for companionship with hospital policy (Muntenda et al, 2017) and inadequate privacy for women on admission (Adinew & Assefa, 2017;Afulani et al, 2017;Bohren et al, 2017;Namujju et al, 2018;Ojelade et al, 2017) reported as reasons why women were denied companionship. Women wanted their loved ones to provide spiritual support usually in the form of prayers to allay their fears during labour (Mensah et al, 2014;Namujju et al, 2018;Ojelade et al, 2017).…”