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Aug 6, 2023Keywords:
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Facilitators and barriers of maternal health service delivery performance in North-West Ethiopia: Experiences of capacity-building program participants
Abstract
Background: Achieving incredible performance is a function of the way in which the health system organizes the six key building blocks. Particularly, strengthening leadership and governance supports understanding the proximate facilitators and barriers of maternal health delivery performance. This study aimed at exploring facilitators and barriers of maternal health performance with special reference on institutional delivery performance in North-West Ethiopia.
Methods: Phenomenological study was conducted from October to November 2018 at health centers located in North-West Ethiopia. Data were collected, until information saturation, from eleven purposively selected keyinformant interviews. Using open code software, data were analyzed thematically. Data were transcribed, coded, categorized and thematized.
Results: Strong management system, enhanced work environment, ambulance, integrated maternal waiting home, and quality maternal service emerged as core dimensions for improved institutional delivery performance. Strong management system was characterized by the involvement of key stakeholders, strong ambulatory health team, functional health development army, and regular pregnant women’s conference. Enhanced work environment was explained by staff morale and ethics, improved staff motivation and commitment and strong health center-health post linkage. The ambulance service was described in terms of ownership, and whether the ambulance was used to transport women home after giving birth. Integrated maternal waiting home was linked to basic services (food, water, and bathroom), cultural ceremonies. Quality maternal service was defined with staff empathy, improved pregnant women counseling, enhanced communication, strong referral linkage, and enhanced customer satisfaction.
Conclusions: Strong management system, enhanced work environment, ambulance, integrated maternal waiting home, and quality service facilitate the institutional delivery performance. Applied research could be conducted to test the practicability of these facilitators.
