Women's perspective of maternity care in Cambodia.
BACKGROUND
Consideration of the needs of pregnant women and their ability and willingness to attend maternal services and pay for them is central to the provision of accessible and acceptable maternal care. Women's satisfaction with maternal services is poorly understood in many developing countries, including Cambodia in South East Asia. The objective of this study was to investigate women's perceptions and experiences of private and public skilled birth attendants, including midwives, during childbirth in Cambodia.


METHODS
A qualitative design using a naturalistic inquiry approach was undertaken to seek sensitive personal issue. Thirty individual in-depth interviews were conducted with women who had recently given birth at private and public health facilities in one province in Cambodia. Data were analysed using a thematic approach.


RESULTS
Women's choice of health facility was influenced by their perceptions of safety and staff attitudes. Reported barriers to the effective utilisation of public maternity services were costs associated with the birth, staff attitudes and a lack of supportive care during labour and in the postpartum period. Although private health care is more expensive than public health care, some women reported a preference for private birth attendants as they perceived them to provide safer and more supportive care in labour.


CONCLUSIONS
Women expect, but do not always receive humane, professional, supportive and respectful treatment from public skilled birth attendants. While the removal of unexpected costs and geographical barriers are important to increasing public maternity care and service utilisation, improvements in maternity services should focus on addressing provider attitudes and enhancing communication skills during labour, birth and the immediate postpartum period.
Faculty of Nursing, Midwifery and Health, University of Technology Sydney, P.O. Box 123, Broadway, NSW 2007, Australia. ponndara.ith@student.uts.edu.au
Ponndara
P
Ith
Angela
A
Dawson
Caroline S E
CS
Homer
D000328:Adult; D001291:Attitude of Health Personnel; D002160:Cambodia; D036861:Delivery, Obstetric / Q000523:psychology*; D005260:Female; D006297:Health Services Accessibility; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D008427:Maternal Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D008880:Midwifery; D009035:Mothers / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction; D010465:Perception; D011181:Postnatal Care; D049590:Postpartum Period; D011247:Pregnancy; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires