2 research outputs found
Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study
Background: Indonesia\u2019s progress on reducing maternal and newborn
mortality rates has slowed in recent years, predominantly in rural
areas. To reduce maternal and newborn mortality, access to quality and
skilled care, particularly at the facility level, is crucial. Yet,
accessing such care is often delayed when maternal and newborn
complications arise. Using the \u201cThree Delays\u201d model
originated by Thaddeus and Maine (1994), investigation into reasons for
delaying the decision to seek care, delaying arrival at a health
facility, and delaying the receiving of adequate care, may help in
establishing more focused interventions to improve maternal and newborn
health in this region. Methods: This qualitative study focused on
identifying, analyzing, and describing illness recognition and
care-seeking patterns related to maternal and newborn complications in
the Jayawijaya district of Papua province, Indonesia. Group interviews
were conducted with families and other caregivers from within 15
villages of Jayawijaya who had either experienced a maternal or newborn
illness or maternal or newborn death. Results: For maternal cases,
excessive bleeding after delivery was recognized as a danger sign, and
the process to decide to seek care was relatively quick. The
decision-making process was mostly dominated by the husband. Most care
was started at home by birth attendants, but the majority sought care
outside of the home within the public health system. For newborn cases,
most of the caregivers could not easily recognize newborn danger signs.
Parents acted as the main decision-makers for seeking care. Decisions
to seek care from a facility, such as the clinic or hospital, were only
made when healthcare workers could not handle the case within the home.
All newborn deaths were associated with delays in seeking care due to
caretaker limitations in danger sign identification, whereas all
maternal deaths were associated with delays in receiving appropriate
care at facility level. Conclusions: For maternal health, emphasis
needs to be placed on supply side solutions, and for newborn health,
emphasis needs to be placed on demand and supply side solutions,
probably including community-based interventions. Contextualized
information for the design of programs aimed to affect maternal and
newborn health is a prerequisite