title: Community-based situation analysis of maternal and neonatal care in South Africa to explore factors that impact utilization of maternal health services.
abstract: This community situational analysis determined factors impacting the utilization of maternal health services in South Africa. Quantitative and qualitative research methods were used, including semistructured household interviews, case studies of women with no antenatal care and/or home birth, and verbal/social autopsies of maternal and infant deaths, conducted in three diverse sites across the country. Data analysis used quantitative statistics for the semistructured interviews and a qualitative thematic content approach for the case studies and verbal/social autopsies. Each component was analyzed separately and then triangulated. The following themes emerged: 1) transport and distance to care were the biggest problems, particularly in rural areas; 2) providers' communication with families was very poor; 3) health-seeking behavior was better than anticipated; 4) treatment by health providers and quality of care showed mixed results; 5) HIV/AIDS is a major issue; however, basic maternity and neonatal service quality cannot be overlooked; and 6) families and communities are an untapped resource for improving maternal and neonatal health. Implications for maternal and infant health care in developing countries are discussed, with a particular focus on barriers to utilization and involvement of communities and families in maternity care.
authors.affiliation: United Nations Population Fund (UNFPA) Regional Directors Team, South Africa.
authors.forename: Pulani
authors.initials: P
authors.lastname: Tlebere
authors.forename: Debra
authors.initials: D
authors.lastname: Jackson
authors.forename: Marian
authors.initials: M
authors.lastname: Loveday
authors.forename: Lyness
authors.initials: L
authors.lastname: Matizirofa
authors.forename: Nomafrench
authors.initials: N
authors.lastname: Mbombo
authors.forename: Tanya
authors.initials: T
authors.lastname: Doherty
authors.forename: Alyssa
authors.initials: A
authors.lastname: Wigton
authors.forename: Latasha
authors.initials: L
authors.lastname: Treger
authors.forename: Mickey
authors.initials: M
authors.lastname: Chopra
mesh_terms: D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D008427:Maternal Health Services / Q000706:statistics & numerical data*; D008429:Maternal Welfare / Q000706:statistics & numerical data*; D008880:Midwifery / Q000458:organization & administration*; D011320:Primary Health Care / Q000706:statistics & numerical data; D012107:Research Design; D019035:Rural Health Services / Q000706:statistics & numerical data*; D013019:South Africa