IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i11p5801-d564320.html
   My bibliography  Save this article

A Qualitative Study to Explore the Barriers for Nonadherence to Referral to Hospital Births by Women with High-Risk Pregnancies in Nepal

Author

Listed:
  • Sushma Rajbanshi

    (Women’s Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia)

  • Mohd Noor Norhayati

    (Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia)

  • Nik Hussain Nik Hazlina

    (Women’s Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia)

Abstract

Maternal and neonatal morbidity and mortality tend to decrease if referral advice during pregnancy is utilized appropriately. This study explores the reasons for nonadherence to referral advice among high-risk pregnant women. A qualitative study was conducted in Morang District, Nepal. A phenomenological inquiry was used. Fourteen participants were interviewed in-depth. High-risk women who did not comply with the referral to have a hospital birth were the study participants. Participants were chosen purposively until data saturation was achieved. The data were generated using thematic analysis. Preference of homebirth, women’s diminished autonomy and financial dependence, conditional factors, and sociocultural factors were the four major themes that hindered hospital births. Women used antenatal check-ups to reaffirm normalcy in their current pregnancies to practice homebirth. For newly-wed young women, information barriers such as not knowing where to seek healthcare existed. The poorest segments and marginalized women did not adhere to referral hospital birth advice even when present with high-risk factors in pregnancy. Multiple factors, including socioeconomic and sociocultural factors, affect women’s decision to give birth in the referral hospital. Targeted interventions for underprivileged communities and policies to increase facility-based birth rates are recommended.

Suggested Citation

  • Sushma Rajbanshi & Mohd Noor Norhayati & Nik Hussain Nik Hazlina, 2021. "A Qualitative Study to Explore the Barriers for Nonadherence to Referral to Hospital Births by Women with High-Risk Pregnancies in Nepal," IJERPH, MDPI, vol. 18(11), pages 1-14, May.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5801-:d:564320
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/11/5801/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/11/5801/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Dujardin, B. & Clarysse, G. & Criel, B. & De Brouwere, V. & Wangata, N., 1995. "The strategy of risk approach in antenatal care: Evaluation of the referral compliance," Social Science & Medicine, Elsevier, vol. 40(4), pages 529-535, February.
    2. Thaddeus, Sereen & Maine, Deborah, 1994. "Too far to walk: Maternal mortality in context," Social Science & Medicine, Elsevier, vol. 38(8), pages 1091-1110, April.
    3. Kenneth Finlayson & Soo Downe, 2013. "Why Do Women Not Use Antenatal Services in Low- and Middle-Income Countries? A Meta-Synthesis of Qualitative Studies," PLOS Medicine, Public Library of Science, vol. 10(1), pages 1-12, January.
    4. Glei, Dana A. & Goldman, Noreen & Rodríguez, Germán, 2003. "Utilization of care during pregnancy in rural Guatemala: does obstetrical need matter?," Social Science & Medicine, Elsevier, vol. 57(12), pages 2447-2463, December.
    5. Gage, Anastasia J., 2007. "Barriers to the utilization of maternal health care in rural Mali," Social Science & Medicine, Elsevier, vol. 65(8), pages 1666-1682, October.
    6. Donovan, Jenny L. & Blake, David R., 1992. "Patient non-compliance: Deviance or reasoned decision-making?," Social Science & Medicine, Elsevier, vol. 34(5), pages 507-513, March.
    7. Amooti-Kaguna, B. & Nuwaha, F., 2000. "Factors influencing choice of delivery sites in Rakai district of Uganda," Social Science & Medicine, Elsevier, vol. 50(2), pages 203-213, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Girma A. Wami & Viktória Prémusz & György M. Csákány & Kovács Kálmán & Viola Vértes & Péter Tamás, 2022. "Characteristics of Homebirth in Hungary: A Retrospective Cohort Study," IJERPH, MDPI, vol. 19(16), pages 1-12, August.
    2. Sushma Rajbanshi & Mohd Noor Norhayati & Nik Hussain Nik Hazlina, 2021. "Perceptions of Good-Quality Antenatal Care and Birthing Services among Postpartum Women in Nepal," IJERPH, MDPI, vol. 18(13), pages 1-13, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Patience A Afulani & Cheryl Moyer, 2016. "Explaining Disparities in Use of Skilled Birth Attendants in Developing Countries: A Conceptual Framework," PLOS ONE, Public Library of Science, vol. 11(4), pages 1-16, April.
    2. Won Ju Hwang & Yeon Mi Park, 2019. "Factors Influencing the Accessibility of Maternal Health Service in Cambodia," IJERPH, MDPI, vol. 16(16), pages 1-10, August.
    3. Edmonds, Joyce K. & Hruschka, Daniel & Bernard, H. Russell & Sibley, Lynn, 2012. "Women’s social networks and birth attendant decisions: Application of the Network-Episode Model," Social Science & Medicine, Elsevier, vol. 74(3), pages 452-459.
    4. Sushma Rajbanshi & Mohd Noor Norhayati & Nik Hussain Nik Hazlina, 2021. "Perceptions of Good-Quality Antenatal Care and Birthing Services among Postpartum Women in Nepal," IJERPH, MDPI, vol. 18(13), pages 1-13, June.
    5. Matsuoka, Sadatoshi & Aiga, Hirotsugu & Rasmey, Lon Chan & Rathavy, Tung & Okitsu, Akiko, 2010. "Perceived barriers to utilization of maternal health services in rural Cambodia," Health Policy, Elsevier, vol. 95(2-3), pages 255-263, May.
    6. Sharmistha Self & Richard Grabowski, 2018. "Factors influencing maternal health care in Nepal: the role of socioeconomic interaction," Asia-Pacific Sustainable Development Journal, United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), vol. 25(2), pages 53-75, December.
    7. De Allegri, Manuela & Ridde, Valéry & Louis, Valérie R. & Sarker, Malabika & Tiendrebéogo, Justin & Yé, Maurice & Müller, Olaf & Jahn, Albrecht, 2011. "Determinants of utilisation of maternal care services after the reduction of user fees: A case study from rural Burkina Faso," Health Policy, Elsevier, vol. 99(3), pages 210-218, March.
    8. Trani, Jean-Francois & Browne, Joyce & Kett, Maria & Bah, Osman & Morlai, Teddy & Bailey, Nicki & Groce, Nora, 2011. "Access to health care, reproductive health and disability: A large scale survey in Sierra Leone," Social Science & Medicine, Elsevier, vol. 73(10), pages 1477-1489.
    9. Nazmul Alam & Mohammad Hajizadeh & Alexandre Dumont & Pierre Fournier, 2015. "Inequalities in Maternal Health Care Utilization in Sub-Saharan African Countries: A Multiyear and Multi-Country Analysis," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-16, April.
    10. Spangler, Sydney A. & Bloom, Shelah S., 2010. "Use of biomedical obstetric care in rural Tanzania: The role of social and material inequalities," Social Science & Medicine, Elsevier, vol. 71(4), pages 760-768, August.
    11. Becker, Stan & Fonseca-Becker, Fannie & Schenck-Yglesias, Catherine, 2006. "Husbands' and wives' reports of women's decision-making power in Western Guatemala and their effects on preventive health behaviors," Social Science & Medicine, Elsevier, vol. 62(9), pages 2313-2326, May.
    12. Esso–Hanam Atake, 2021. "Socio‐economic inequality in maternal health care utilization in Sub‐Saharan Africa: Evidence from Togo," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(2), pages 288-301, March.
    13. Van Rijsbergen, Bart & D’Exelle, Ben, 2013. "Delivery Care in Tanzania: A Comparative Analysis of Use and Preferences," World Development, Elsevier, vol. 43(C), pages 276-287.
    14. Adjiwanou, Vissého & LeGrand, Thomas, 2013. "Does antenatal care matter in the use of skilled birth attendance in rural Africa: A multi-country analysis," Social Science & Medicine, Elsevier, vol. 86(C), pages 26-34.
    15. Chitalu M. Chama-Chiliba & Steven F. Koch, 2014. "Assessing Regional Variations in the Effect of the Removal of User Fees on Institutional Deliveries in Rural Zambia," Working Papers 201417, University of Pretoria, Department of Economics.
    16. Jerome K Kabakyenga & Per-Olof Östergren & Eleanor Turyakira & Karen Odberg Pettersson, 2012. "Influence of Birth Preparedness, Decision-Making on Location of Birth and Assistance by Skilled Birth Attendants among Women in South-Western Uganda," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-8, April.
    17. Guliani, Harminder & Sepehri, Ardeshir & Serieux, John, 2012. "What impact does contact with the prenatal care system have on women’s use of facility delivery? Evidence from low-income countries," Social Science & Medicine, Elsevier, vol. 74(12), pages 1882-1890.
    18. Gayen, Kaberi & Raeside, Robert, 2007. "Social networks, normative influence and health delivery in rural Bangladesh," Social Science & Medicine, Elsevier, vol. 65(5), pages 900-914, September.
    19. Sanni Yaya & Ghose Bishwajit & Michael Ekholuenetale & Vaibhav Shah & Bernard Kadio & Ogochukwu Udenigwe, 2017. "Timing and adequate attendance of antenatal care visits among women in Ethiopia," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-16, September.
    20. Kasim Allel & Gerard Abou Jaoude & Stavros Poupakis & Neha Batura & Jolene Skordis & Hassan Haghparast-Bidgoli, 2021. "Exploring the Associations between Early Childhood Development Outcomes and Ecological Country-Level Factors across Low- and Middle-Income Countries," IJERPH, MDPI, vol. 18(7), pages 1-15, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5801-:d:564320. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.