BARRIERS TO TREATMENT OF OBSTETRIC EMERGENCIES IN RURAL COMMUNITIES OF WEST AFRICA

This article is the result of a collaborative effort among the researchers of the Prevention of Maternal Mortality Network. The network consists of 12 multidisciplinary teams, 11 in West Africa and one based at Columbia University in New York. This article summarizes exploratory research conducted by the African teams using focus-group discussions in rural communities in Nigeria, Ghana, and Sierra Leone. The objective was to identify barriers to the use of health-care facilities when obstetric problems arise. The findings illustrate how sociocultural factors, such as societal expectations and the role of women, affect the use of health services. Physical and social distance between communities and facilities, as well as transportation problems, were found to be obstacles to care. Health-service factors were also found to pose barriers to prompt treatment. This article also provides an example of how qualitative methodology can be used to obtain substantive information about a community's frustrations and needs with respect to health care.