title: What prevent women for a sustainable use of maternal care in two medical districts of Burkina Faso? A qualitative study.
abstract: BACKGROUND
  Skilled attendance is one of the major strategies to curtail maternal mortality, specifically in developing countries. Despite the low level of equipment, it is only in health facilities that skilled care are provided during pregnancy and childbirth; but there are some barriers which prevent women to use health facilities for good care.
  
  
  METHODS
  This study was carried out in Ouargaye where a skilled care initiative was implemented by Family care International with the aim to increase the skilled attendance at delivery and Diapaga, the control district. Thirty (30) In-depth interviews, 8 Focus group discussions and 6 non participant observations were carried out. Participants were women from 15-49 years. All the interviews were tape-recorded, transcribed and analysed line by line. NVIVO was used to manage the interviews.
  
  
  RESULTS
  Four types of barriers have been described by women; 1) the cultural barriers concern the low status of women in the two districts and some traditional beliefs which mean that women can not always decide to use health facility by themselves. 2) The geographical barrier is about the distance to reach health facility and the lack of transport means. 3) The financial barrier to pay care and drugs. 4) Bad organization of care and poor quality of care provided to women.
  
  
  CONCLUSIONS
  To minimize the risk of complications during pregnancy and childbirth, it is important that women use health facilities. The barriers described by women are not insurmountable but needed to be integrated in a global comprehensive health policy.
authors.affiliation: Société d'Etudes et de Recherche en Santé Publique, Ouagadougou (SERSAP), Burkina Faso.
authors.forename: Donmozoun Télesphore
authors.initials: DT
authors.lastname: Somé
authors.affiliation: West African Health Organization (WAHO), Bobo-Dioulasso, Burkina Faso.
authors.forename: Issiaka
authors.initials: I
authors.lastname: Sombie
authors.affiliation: Centre MURAZ, Bobo-Dioulasso, Burkina Faso.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meda
mesh_terms: D000293:Adolescent; D000328:Adult; D002050:Burkina Faso; D003466:Cultural Characteristics; D003625:Data Collection; D036861:Delivery, Obstetric / Q000379:methods* / Q000592:standards; D005260:Female; D017144:Focus Groups; D006801:Humans; D008427:Maternal Health Services / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D008428:Maternal Mortality; D008875:Middle Aged; D011247:Pregnancy; D014187:Transportation of Patients / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Burkina Faso; Maternal care; medical district; rural; skilled care