%0 Journal Article
%T High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention
%A Moke Magoma
%A Jennifer Requejo
%A Oona MR Campbell
%A Simon Cousens
%A Veronique Filippi
%J BMC Pregnancy and Childbirth
%D 2010
%I BioMed Central
%R 10.1186/1471-2393-10-13
%X Twelve key informant interviews and fifteen focus group discussions were held with Maasai and Watemi women, traditional birth attendants, health care providers, and community members. Principles of the grounded theory approach were used to elicit and assess the various perspectives of each group of participants interviewed.The Maasai and Watemi women's preferences for a home birth and lack of planning for delivery are reinforced by the failure of health care providers to consistently communicate the importance of skilled delivery and immediate post-partum care for all women during routine antenatal visits. Husbands typically serve as gatekeepers of women's reproductive health in the two groups - including decisions about where they will deliver- yet they are rarely encouraged to attend antenatal sessions. While husbands are encouraged to participate in programs to prevent maternal-to-child transmission of HIV, messages about the importance of skilled delivery care for all women are not given emphasis.Increasing coverage of skilled delivery care and achieving the full implementation of Tanzania's Focused Antenatal Care Package in Ngorongoro depends upon improved training and monitoring of health care providers, and greater family participation in antenatal care visits.Three core health sector strategies are identified within the maternal health community as critical for reducing maternal and early neonatal deaths. These include comprehensive reproductive health care; skilled care for all pregnant women, especially during delivery; and emergency obstetric care for all women and infants with life-threatening complications [1]. Political commitment to maternal and newborn health has historically been low, however, and most women in developing countries do not receive these recommended aspects of care. Maternal mortality remains high in the developing world and contrasts sharply with the low levels of maternal mortality in developed countries. Comparison of the lifetime
%U http://www.biomedcentral.com/1471-2393/10/13