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A mixed methods assessment of barriers to maternal, newborn and child health in gogrial west, south Sudan.
Reprod Health. 2017 Jan 19; 14(1):12.RH

Abstract

BACKGROUND

Health conditions for mothers, newborns, and children in South Sudan are among the worst worldwide. South Sudan has the highest rate of maternal mortality in the world and despite alarming statistics, few women and children in South Sudan have access to needed healthcare, especially in rural areas. The purpose of this study was to understand the barriers to maternal, newborn and child health in Gogrial West, Warrap State, South Sudan, one of the most underdeveloped states.

METHODS

A randomized household quantitative study and supplemental qualitative interviews were employed in 8/9 payams in Gogrial West, Warrap, South Sudan. Interviews were conducted with randomly selected female household members (n = 860) who were pregnant or had children less than 5 years of age, and men (n = 144) with a wife having these characteristics. Non-randomized qualitative interviews (n = 72) were used to nuance and add important socio-cultural context to the quantitative data. Analysis involved the estimation of weighted population means and percentages, using 95% confidence intervals and considering p-values as significant when less than 0.05, when comparisons by age, age of marriage, wife status and wealth were to be established.

RESULTS

Most women (90.8%) and men (96.6%) did not want contraception. Only 1.2% of women aged 15-49 had met their need for family planning. On average, pregnant women presented for antenatal care (ANC) 2.3 times and by unskilled providers. Less than half of households had a mosquito net; fewer had insecticide treated nets. Recognition of maternal, newborn and child health danger signs overall was low. Only 4.6% of women had skilled birth attendants. One quarter of children had verifiable DPT3 immunization. Five percent of men and 6% of women reported forced intercourse. Overall men and women accept beatings as a norm.

CONCLUSION

Barriers to care for mothers, infants and children are far more than the lack of antenatal care. Maternal, newborn and child health suffers from lack of skilled providers, resources, distance to clinics. A lack of gender equity and accepted negative social norms impedes healthy behaviors among women and children. The paucity of a peer-reviewed evidence base in the world's newest country to address the overwhelming needs of the population suggests these data will help to align health priorities to guide programmatic strategy for key stakeholders.

Authors+Show Affiliations

Overseas Strategic Consulting, Ltd, 1500 Walnut Street, Suite 1300, Philadelphia, PA, 19102, USA. llawry@ihresearch.org., Poeta Esteban Villegas, 12, 12°B 28014, Madrid, Spain., 609 Aquaview Drive, Ottawa, ON, K4A 4W1, Canada.Canadian Red Cross, National Office, 170 Metcalfe Street, Suite 300, Ottawa, ON, CA K2P2P2, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28103891

Citation

Lawry, Lynn, et al. "A Mixed Methods Assessment of Barriers to Maternal, Newborn and Child Health in Gogrial West, South Sudan." Reproductive Health, vol. 14, no. 1, 2017, p. 12.
Lawry L, Canteli C, Rabenzanahary T, et al. A mixed methods assessment of barriers to maternal, newborn and child health in gogrial west, south Sudan. Reprod Health. 2017;14(1):12.
Lawry, L., Canteli, C., Rabenzanahary, T., & Pramana, W. (2017). A mixed methods assessment of barriers to maternal, newborn and child health in gogrial west, south Sudan. Reproductive Health, 14(1), 12. https://doi.org/10.1186/s12978-016-0269-y
Lawry L, et al. A Mixed Methods Assessment of Barriers to Maternal, Newborn and Child Health in Gogrial West, South Sudan. Reprod Health. 2017 Jan 19;14(1):12. PubMed PMID: 28103891.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A mixed methods assessment of barriers to maternal, newborn and child health in gogrial west, south Sudan. AU - Lawry,Lynn, AU - Canteli,Covadonga, AU - Rabenzanahary,Tahina, AU - Pramana,Wartini, Y1 - 2017/01/19/ PY - 2016/03/28/received PY - 2016/12/20/accepted PY - 2017/1/21/entrez PY - 2017/1/21/pubmed PY - 2017/5/5/medline KW - MNCH KW - Sexual Gender Based Violence KW - South Sudan SP - 12 EP - 12 JF - Reproductive health JO - Reprod Health VL - 14 IS - 1 N2 - BACKGROUND: Health conditions for mothers, newborns, and children in South Sudan are among the worst worldwide. South Sudan has the highest rate of maternal mortality in the world and despite alarming statistics, few women and children in South Sudan have access to needed healthcare, especially in rural areas. The purpose of this study was to understand the barriers to maternal, newborn and child health in Gogrial West, Warrap State, South Sudan, one of the most underdeveloped states. METHODS: A randomized household quantitative study and supplemental qualitative interviews were employed in 8/9 payams in Gogrial West, Warrap, South Sudan. Interviews were conducted with randomly selected female household members (n = 860) who were pregnant or had children less than 5 years of age, and men (n = 144) with a wife having these characteristics. Non-randomized qualitative interviews (n = 72) were used to nuance and add important socio-cultural context to the quantitative data. Analysis involved the estimation of weighted population means and percentages, using 95% confidence intervals and considering p-values as significant when less than 0.05, when comparisons by age, age of marriage, wife status and wealth were to be established. RESULTS: Most women (90.8%) and men (96.6%) did not want contraception. Only 1.2% of women aged 15-49 had met their need for family planning. On average, pregnant women presented for antenatal care (ANC) 2.3 times and by unskilled providers. Less than half of households had a mosquito net; fewer had insecticide treated nets. Recognition of maternal, newborn and child health danger signs overall was low. Only 4.6% of women had skilled birth attendants. One quarter of children had verifiable DPT3 immunization. Five percent of men and 6% of women reported forced intercourse. Overall men and women accept beatings as a norm. CONCLUSION: Barriers to care for mothers, infants and children are far more than the lack of antenatal care. Maternal, newborn and child health suffers from lack of skilled providers, resources, distance to clinics. A lack of gender equity and accepted negative social norms impedes healthy behaviors among women and children. The paucity of a peer-reviewed evidence base in the world's newest country to address the overwhelming needs of the population suggests these data will help to align health priorities to guide programmatic strategy for key stakeholders. SN - 1742-4755 UR - http://www.nlm.medscape.idmu.unboundmedicine.unboundmedicine.com/medline/citation/28103891/A_mixed_methods_assessment_of_barriers_to_maternal_newborn_and_child_health_in_gogrial_west_south_Sudan_ L2 - https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-016-0269-y DB - PRIME DP - Unbound Medicine ER -