Behavior Profile: Delivery in Health Facility| Health Goal: Improve maternal and child survival | ||
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Pregnant women deliver in a health facility with an equipped, qualified provider Indicator: Percentage of live births in the three years preceding the survey delivered at a health facility
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Behavior Analysis |
Strategy | ||
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BEHAVIOR AND STEPSWhat steps are needed to practice this behavior?Pregnant women deliver in a health facility with an equipped, qualified provider
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FACTORSWhat factors may prevent or support practice of this behavior?StructuralAccessibility: Pregnant women do not deliver in a health facility, especially in an emergency, because facilities are often far from households and transportation is difficult to find. Accessibility: Pregnant women are unable to deliver in a health facility because maternity care is not always free. Service Provider Competencies: Pregnant women do not receive all required services from a health facility because they want to avoid negative provider attitudes and treatment. Service Experience: Pregnant women cannot deliver in a health facility because not all clinics are open or staffed 24 hours. SocialGender: Pregnant women do not have support from their partners to pursue and mobilize resources for delivery in a health facility because due to tradition, lack of information, lack of accommodation, and the exclusion of men in the maternal health system. Norms: Pregnant women do not deliver in a facility because traditional birthing practices and preferences differ from experiences in clinics. InternalAttitudes and Beliefs: Pregnant women choose to deliver at a health facility because they want a healthy baby. Attitudes and Beliefs: Pregnant women do not deliver in a facility because many women perceive the quality of care from a clinic as no better than care from a traditional birth attendant at home. |
SUPPORTING ACTORS AND ACTIONSWho must support the practice of this behavior, and what actions must they take?InstitutionalPolicymakers: Ensure affordability of care for most vulnerable via insurance schemes, CCTs, or other financing. Policymakers: Review staffing policy to ensure maternity care is accessible 24 hours. Managers: Explore ways to offer more of what women want for their delivery in clinic setting. Providers: Offer respectful care to clients. Providers: Actively engage men in pregnancy and delivery decisions. CommunityCommunity Leaders: Support women with transport costs and logistics, including facilitation of community solutions like building maternity waiting shelters. HouseholdMale Partners: Actively participate in childbirth related decisions and encourage partners to deliver in a facility. |
POSSIBLE PROGRAM STRATEGIESWhat strategies will best focus our efforts based on this analysis?Strategy requires Communication Support Enabling EnvironmentFinancing: Create national insurance schemes, use conditional cash transfers (CCTs) or establish community savings schemes to ensure all are able to access maternity services.
Partnerships and Networks: Expand delivery of labor and delivery as well as EMONC services beyond formal system via avenues like social franchising.
Policies and Governance: Strengthen human resources allocation to ensure 24 hour coverage at all EmONC sites and referral systems. Policies and Governance: Allow non-harmful traditional birthing practices at clinics. Systems, Products and ServicesInfrastructure: Explore creation of waiting shelters for mothers. Quality Improvement: Ensure providers are well-trained in and offer respectful maternity care. Demand and UseCommunication: Use targeted media, including SMS where possible, to promote the improved quality of care and tailor reminders and tips for pregnant women and their families, self-created locally appropriate or picture-based birth plans. Communication: Leverage traditional birth attendants for counseling, referrals and support to women and families in planning for and delivering in a facility, including distribution of birthing kits. Collective Engagement: Engage community leaders and men to diffuse responsibility for women's health care. |
