Gender dynamics affecting maternal health and health care access and use in Uganda

Datos Bibliográficos

ID11490683
AutoresRosemary Morgan (0000-0001-5009-8470, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA), Moses Tetui (0000-0001-6833-7601, Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda, autor de correspondencia), Rornald Muhumuza Kananura (0000-0002-9915-1989, Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda), Elizabeth Ekirapa-Kiracho (Department of Health Policy Planning and Management, Makerere University School of Public Health, Kampala, Uganda), Elizabeth Ekirapa Kiracho (0000-0001-6938-2068, Makerere University), Asha George (0000-0002-5968-1424, University of the Western Cape), A S George (Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA)
Año2017
Volumen32
Númerosuppl_5
Páginasv13-v21
Fecha de publicación2017-12-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czx011
PMID29244103
OpenAlexW2772809998
IdiomaEN
Citas recibidas37
Referencias citadas22

Despite its reduction over the last decade, the maternal mortality rate in Uganda remains high, due to in part a lack of access to maternal health care. In an effort to increase access to care, a quasi-experimental trial using vouchers was implemented in Eastern Uganda between 2009 and 2011. Findings from the trial reported a dramatic increase in pregnant women's access to institutional delivery. Sustainability of such interventions, however, is an important challenge. While such interventions are able to successfully address immediate access barriers, such as lack of financial resources and transportation, they are reliant on external resources to sustain them and are not designed to address the underlying causes contributing to women's lack of access, including those related to gender. In an effort to examine ways to sustain the intervention beyond external financial resources, project implementers conducted a follow-up qualitative study to explore the root causes of women's lack of maternal health care access and utilization. Based on emergent findings, a gender analysis of the data was conducted to identify key gender dynamics affecting maternal health and maternal health care. This paper reports the key gender dynamics identified during the analysis, by detailing how gender power relations affect maternal health care access and utilization in relation to: access to resources; division of labour, including women's workload during and after pregnancy and lack of male involvement at health facilities; social norms, including perceptions of women's attitudes and behaviour during pregnancy, men's attitudes towards fatherhood, attitudes towards domestic violence, and health worker attitudes and behaviour; and decision-making. It concludes by discussing the need for integrating gender into maternal health care interventions if they are to address the root causes of barriers to maternal health access and utilization and improve access to and use of maternal health care in the long term.

Business · Developing country · Economic growth · Economics · Environmental health · Health care · Health services · Maternal health · Population · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Poverty, Education, and Child Welfare