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conferenceseries
.com
Volume 9
Journal of Community Medicine & Health Education
Public Health Congress 2019
May 15-16, 2019
May 15-16, 2019 Singapore
7
th
World Congress on
Public Health, Nutrition & Epidemiology
Notes:
J Community Med Health Educ 2019, Volume 9
DOI: 10.4172/2161-0711-C3-060
No roads to health: Lessons from health service delivery in rural communities of Sub-Saharan
Africa
Olusimbo Ige, Kathleen Griffith and Graciela Salvador Davila
Global Ministries, USA
G
lobally, the numbers of stillborn babies, neonatal deaths and maternal deaths are reducing as a result of focused efforts on
low and middle-income countries. However, in many rural communities, progress remains slow particularly when there is
limited access to skilled medical attendants during delivery. In response, since 2015, our organization has been implementing
Maternal, Newborn and ChildHealth (MNCH) programs in Sub-Saharan Africa, where women are plagued bymany challenges
in seeking obstetric care. This study highlights persistent barriers to obstetric care in certain rural populations. Mixed methods
were used to explore barriers to institutional delivery in target countries. Qualitative data were collected through Participatory
Rural Appraisal (PRA) with groups of service providers, expectant mothers during antenatal clinics, mothers presenting in
labor, community health volunteers, mothers in the communities served by the rural maternity centers. Notes taken during
PRA sessions were edited, triangulated and coded according to recurring issues. Additionally, participants used matrix ranking
to express their perceived relative significance of the barriers identified. After three years of programs many underserved
communities’ pregnant women now receive an integrated package of antenatal, childbirth and post-partum care. However,
despite all the efforts made to increase institutional deliveries, numbers continue to lag in many rural communities where less
than 50% of the mothers who attend antenatal clinic come back to have their babies at the maternity center. Factors related
to limited household income, non-availability of means of transportation and physical inaccessibility of roads were highly
ranked barriers to utilization of institutional delivery. Time to walk to the health facility ranged from 1-3 hours in many rural
communities. It appears that the challenges to be met to increase institutional delivery are not new technologies nor new
knowledge about effective interventions, the real challenge is how to improve road access to health facilities. Multi-sectoral
approach is imperative to success since the main barriers to obstetric care appear to be outside the scope of the health sector.
oige@umcmission.org