It's about mothers- A qualitative study on the utilization of maternal care at Kawempe Health Centre-Kampala

Abstract

This qualitative study is focused on understanding the why, what, when and how of maternal care utilization at Kawempe Health Centre (KHC), one of the biggest governmental run health centers in Kampala, Uganda. KHC lies in Kawempe division, one of Kampala’s five divisions and probably also the poorest. KHC was chosen with the help of The Liverpool-Mulago Partnership for Women’s and Children’s Health (LMP), an organization that tries to reduce the high maternal mortality rate in Uganda by providing governmental run health centres such as KHC with necessary equipment, skills and expertise. KHC is one of the governmental run health centers supported by LMP that has to cope with many problems ranging from unmotivated staff to lack of medicine, equipment and an ambulance. Yet, maternal deaths cannot solely be reduced by providing health centers with the necessary means- a better understanding of the personal situation of users of maternal care is also needed to provide care that fits the expectations and needs of its users. Therefore, this study tries to explain which factors are of influence on the utilization of maternal care.

The focus lies on local women that are pregnant and make use of antenatal care and women that have just given birth and make use of postnatal care at KHC. By letting 40 women tell their story, a better insight into the way in which utilization of maternal care is being shaped, has been provided. Central to the interviews are the socioeconomic and cultural background of the women; the accessibility and quality of care and the perceptions of these women on the care provided to them. These three topics are drawn from the Access model of Peters et al.(2008) which has functioned as an analytical model to study the different components of health-seeking behavior of local women at KHC. Therefore, other actors have also been drawn into this study. As the situation at KHC is poor, staff members have also been interviewed and incorporated to understand their side of the story. Their perceptions and opinions on the problems surrounding the provision of maternal care help to put the stories of the users in perspective. Further, community leaders and experts in the field of (maternal) care and health have also been interviewed to put the way in which maternal care at KHC is used and provided in a broader perspective.