title: Tibetan women's perspectives and satisfaction with delivery care in a rural birth center.
abstract: OBJECTIVE
  To identify sociodemographic characteristics and factors involved in Tibetan women's decisions to deliver at the Tibetan Birth and Training Center (TBTC) in rural western China.
  
  
  METHODS
  In the present mixed-methods study, a random sample of married women who delivered at the TBTC between June 2011 and June 2012 were surveyed. Additionally, four focus group discussions were conducted among married women living in the TBTC catchment area. Descriptive analyses were conducted, and dominant themes were identified.
  
  
  RESULTS
  In focus group discussions, women (n=33) reported that improved roads and transportation meant that access to health facilities was easier than in the past. Although some of the 114 survey participants voiced negative perceptions of healthcare facilities and providers, 99 (86.8%) indicated that they chose to deliver at the TBTC because they preferred to have a doctor present. Most women (75 [65.8%]) said their mother/mother-in-law made the final decision about delivery location. Women valued logistic and cultural aspects of the TBTC, and 108 (94.7%) said that they would recommend the TBTC to a friend.
  
  
  CONCLUSIONS
  Study participants preferred delivery care that combines safety and comfort. The findings highlight avenues for further promotion of facility delivery among populations with lower rates of skilled deliveries.
authors: Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA; California Center for Population Research, UCLA, Los Angeles, CA, USA. Electronic address: jgipson@ucla.edu.
authors: Jessica D
authors: JD
authors: Gipson
authors: Tso-ngon (Qinghai) University Tibetan Medical College (TUTMC), Xining City, Qinghai Province, China; Kumbum Tibetan Medical Hospital, Kumbum Monastery, Lusar (CH: Huangzhong), Qinghai Province, China.
authors: Kunchok
authors: K
authors: Gyaltsen
authors: Tso-ngon (Qinghai) University Tibetan Medical College (TUTMC), Xining City, Qinghai Province, China.
authors: Lhusham
authors: L
authors: Gyal
authors: Tibetan Birth and Training Center, Tongren County of Huangnan Prefecture, Qinghai Province, China.
authors: Tsering
authors: T
authors: Kyi
authors: California Center for Population Research, UCLA, Los Angeles, CA, USA; Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
authors: Andrew L
authors: AL
authors: Hicks
authors: Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles (UCLA), Los Angeles, CA, USA; California Center for Population Research, UCLA, Los Angeles, CA, USA.
authors: Anne R
authors: AR
authors: Pebley
mesh_terms: D000293:Adolescent; D000328:Adult; D016550:Birthing Centers / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D065246:Culturally Competent Care; D003657:Decision Making; D036861:Delivery, Obstetric / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D005195:Family Relations; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility; D006700:Home Childbirth / Q000191:economics; D006801:Humans; D017060:Patient Satisfaction; D010465:Perception; D010817:Physician-Patient Relations; D019035:Rural Health Services / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D018609:Tibet; D014186:Transportation; D055815:Young Adult
keywords: Delivery care; Ethnic minority populations; Facility delivery; Health facility; Tibet