To browse Academia. Poor and disadvantaged groups in developing countries, especially in Sub-Saharan Africa, face various barriers to access and use of preventive and curative health services. Women are among the most disadvantaged groups in Tanzania and rural women are most affected because they live far from local and referral hospitals. While the National Health Policy of Tanzania provides free maternal health services for pregnant women, utilisation of the services is still low.
This thesis investigates barriers and enablers to access to health care services by pregnant women in rural villages of Kerege, Matumbi, Kiromo and Kitopeni in Bagamoyo district, Tanzania. The study used a naturalistic ethnographic approach, which focused on intensive listening to the stories and experiences of pregnant respondents and male spouses using in-depth interviews, focus group discussions and observation as methods of data collection.
In-depth interviews were conducted with sixteen women and four focus group discussions with thirty two men, and interviews with six health workers were combined with observation at selected government health facilities. The opinions and experiences of health care personnel about the experiences and challenges they perceive as confronting pregnant women and mothers who access health care services were sought. The thesis identified issues around transport, antenatal care services, child delivery, HIV testing and family planning as of significant importance with regard to access to health care services from study participants' perspectives.
The main study findings include: distance, poor road infrastructure, lack of transport, inadequate mode of transportation, costs of transport, lack of equipment and supplies, cost of supplies for delivery, lack of amenities water and electricity , lack of space and privacy, poor health infrastructure, health care personnel shortage and heavy workload, inadequate funding, social cultural barriers, gender inequality, lack of male participation, inadequate contraception supplies, lack of choice for contraception and lack of training.
The thesis provides recommendations to government to assist pregnant women access health care services vii easily and conveniently; to help health care personnel execute their work effectively and efficiently; and to devise workable solutions for improving performance of low level health facilities in rural areas. The thesis informs the existing knowledge in both. Prenatal care and having a skilled attendant present during delivery significantly reduces maternal mortality by identifying complications early and having someone present to deal with new problems as they occur World Health Organization [WHO], ; Department of Reproductive Health Research [DRHR] WHO, The primary question of this study was: Which, if any, of the barriers to the use of healthcare services during pregnancy commonly cited in the literature are present in the Singida Region of Tanzania?
