Gender-based social norms, psychosocial variation, and power relations during delivery and post natal care: a case study qualitative research in rural Ethiopia

Abstract

ABSTRACTBackgroundThe World Health Organization (WHO) strongly encouraged men to support women to use maternal health care services. However, especially in developing countries, maternal health care has traditionally been viewed as a women’s issue, men making little or no contribution, despite the fact that sexuality and children are shared products. The study’s goal was to understand how gender-based norms, psychosocial variation, power relations, and community social support are related to child delivery and post-natal care services.MethodThe study took place in three rural districts of Ethiopia’s Oromia regional state, Jimma Zone. An in-depth interview and focus group discussion were held with a group of carefully chosen health professionals, community health development armies, and religious leaders. The data was collected, translated, and transcribed by men and women with experience in qualitative research. For data analysis, Atlas ti version 9 was used. Gender-based delivery and postnatal care service utilization were investigated using gender-based categories.ResultIndependent and shared gender-based roles were identified as a means to improve maternal health-care services delivery. Men have the ability to persuade pregnant women to use delivery services and post-natal care. The place of delivery is determined by the levels of gender power relations at the household level, but women are usually the last decision-makers. Furthermore, the community’s belief that giving birth in a health facility makes women look clean and neat, as opposed to home delivery, increases their intention to use maternal health care services..ConclusionUnderstanding men’s and women’s roles, knowledge levels, beliefs, decision-making, and social support significantly improves maternal health care service utilization, allowing pregnant women to receive delivery services at a health facility. Pregnant women were the last to make a decision about using maternal health care services. There are still gaps in knowledge and negative beliefs about maternal health care that limit delivery and postnatal service utilization.RecommendationIncreasing community-level social support can significantly improve maternal health care service delivery. Men’s concern about institutional delivery is increased when they are viewed as the primary audience during maternal health education. Researchers should focus on the mechanisms through which men participate in delivery in the future, and postnatal services will fully address men’s involvement in maternal health care services.