Zambian Women's Experiences of Urban Maternity Care: Results from a Community Survey in Lusaka
Abstract
Urban African maternity care systems face problems, as rapid population growth puts them under increasing pressure. In 1983 a decentralised system with midwife-run maternity units at health centres was initiated in Lusaka. A community-based survey of 1210 women conducted in 1999 examined access, coverage and quality of care in these maternity services. Results were generally positive: 99% of respondents received some antenatal check-ups and three quarters had five or more. Institutional delivery rate was 89.5%. Home birth was associated with belonging to a "very poor" household. Sixty three per cent of births were in the decentralised units. Eighty nine per cent reported care as "good" or ``very good", but 21% remembered someone who had treated them badly during labour, principally by shouting or scolding. One fifth of women reported having been left alone for "too long" in labour. Less than half of the women said they would like a lay labour companion and three quarters would prefer a companion at the delivery. (Afr J Reprod Health 2003; 7[1]: 92-102)
Keywords: Zambia, maternity services, labour companions, home birth
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Rossi EE. Meeting the growing demand for quality reproductive health services in urban Africa: partnerships with municipal governments. SEATS Project, John Snow Inc, Arlington, 2000.
Atkinson S, Ngwengwe A, Macwan'gi M, Ngulube TJ, Harpham T and O'Connell A. The referral process and urban health c are in sub-Saharan Africa: the case of Lusaka. ZamSocSci Med 1999; 49(1): 27-38.
World Resources Institute. World resources report Table El. 3. Distribution of income and poverty, 2000. http://www.earthtrends.wri.org/pdf_library/ data_tables /ei3n_2000.PDF
Medical Research Council of South Africa. Local authority response to HIV/AIDS: an overview of key cities. Urban Health Dev Bull 2000; 3(2). http://www.mrc.ac.za/urbanbulletin/june200/local authority.htm
NasahBTand Tyndall M. Emerging problems of maternity care in urban settings. In: BT Nasah, JKG Mati and JM Kasonde (Eds.). Contemporary Issues in Maternal Health Care in Africa. Luxembourg: Harwood Academic Publishers, 1994, 67-87.
Irish Aid Evaluation and Audit Unit. Evaluation report, Lusaka urban maternity clinics project, Zambia, 1999.
Central Statistics Office. Living conditions monitoring survey report, 1996.
Central Statistics Office, Ministry of Health and Macro International Inc. Zambia demographic and health survey 1996.
Shearer BC. How do parents really feel after caesarean birth? Birth 1983; 10: 91-92.
Lumley J. Assessing satisfaction with childbirth. Birth 1985; 12(3): 141-145.
Bennett A. The birth of a first child: do women's reports change over time? Birth 1985; 12: 153-158.
Gilson L, Alilio M and Heggenhougen K. Community satisfaction with primary health care services: an evaluation undertaken in the Morogoro region of Tanzania. SocSci Med 1994; 39(6): 767-780.
Hodnett ED. Support from caregivers during childbirth. Coch Rev 2000; 4.
Maduma-Butshe A, Dyall A and Garner P. Routine episiotomy in developing countries. Br Med J 1998; 316: 1179-1180.
Jewkes R, Abrahams N and Mvo Z. Why do nurses abuse patients? Reflections from South African obstetric services. SocSci Med 1998; 47(11): 1781-1795.
Bassett M, Bijlmakers L and Sanders D. Professionalism, patient satisfaction and quality of health care experience during Zimbabwe's structural adjustment programme. SocSci Med 1997; 4(12): 1845-1852.
WHO. Health Workers for Change: A Manual to Improve Quality of Care. Geneva: WHO, 1995.
Klaus MH, Kennell JH, Robertson SS and Sosa R. Effects of social support during parturition on maternal and infant morbidity. Br Med J 1986; 293(6547): 585-587.
Chalmers B and Porter R. Assessing effective care in normal labour: the Bologna score. Birth 2001; 28(2): 79-83.
Murray SF, Davies S, KumwendaPhiri R and Ahmed Y. Tools for monitoring the effectiveness of district maternity referral systems. Health Pol Plann 2001; 16(4): 353-361.
TALC/Quadreto. How to Make Maternal Health Services more Women-friendly. A Practical Guide Teaching Aids at Low Cost. London, 2001.
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