Factors contributing to poor utilization of public health facilities for maternity care Services at Mpumalanga Province, South Africa

Abstract

Utilizing maternity care services as soon as possible will guarantee maternal health and ensure that babies have the best possible start in life. Around 75% of births occur outside of a health facility worldwide which means that it is rare for experienced midwives to be present in these situations. Despite all the efforts the Department of Health makes to implement standards and develop programs like the South African Maternal, Perinatal, and Neonatal Health Policy, Basic Antenatal Care Approach, traditional approach, and updating standards to minimise maternal mortality rate and complications, poor utilization of public health facilities for maternity care services remains high in rural based health facilities of Ehlanzeni district. Therefore, this study aimed at identifying and describing factors that contribute to poor utilization of public health facilities for maternity care services at Thulamahashe local region, Bushbuckridge local municipality of Mpumalanga Province, South Africa. A quantitative cross-sectional descriptive design was employed for this study. A questionnaire was employed and simple random probability was used to select 204 pregnant women from the six selected primary health facilities of Thulamahashe local region. The sample size was calculated using Slovin’s formula. A pre-test of the data collection instrument was done on 22 respondents from one of the selected health facilities. The researcher used Excel and the statistics program SPSS version 30.0. This software produces tables, charts, and numerical statistical measures with the click of a mouse. Validity and reliability were maintained. Ethical standards such as permission to conduct the study, informed consent, confidentiality and privacy, principle of beneficiary, respect and human rights and justice were taken into consideration. The study indicated that core barriers for maternity care service utilisation listed by respondents were that they were waiting for too long in the healthcare facility, fear of being scolded by midwives, distance from home to the health facility and lack of education. The conclusion drawn from this study is that awareness to maternity care services utilisation needs to be consistently raised so that utilisation might increase. Pregnant women are encouraged to initiate ANC services as soon as they find out they are pregnant and Nurses’ attitude should be addressed through trainings on interpersonal communication skills.