Social-cultural norms influencing the utilization of child delivery and neonatal care services among Karimojong mothers in Nadunget sub-county, Moroto district
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Every year, nearly 45% of all under 5 child deaths are among newborn infants, babies in their first 28 days of life or the neonatal period (World Health Organisation, 2016). Every day in 2015, 830 women died from preventable causes related to pregnancy and child birth (World Health Organization, 2016), and almost all maternal deaths (99%) happen in developing countries. Studies have indicated that among the many causes for the high maternal and infant mortality rates in developing countries, the most prominent one is that women give birth at home, with the help of traditional birth attendants, relatives, neighbors or even on their own (Lynn M Sibley, 2012). Moreover, most of these mothers and their partners, especially in rural areas, have more trust in the traditional birth attendants than in the trained birth attendants in health facilities, (Sundal, 2012). More than 40 million unattended births are in low and middle – income countries and in these countries, a larger percentage occurs in rural areas. In Uganda, 74% of the live births were attended to by skilled providers and 73% in the health facility, of which 90% of the births were to urban mothers, compared to 70% that were to rural mothers (Uganda Demographic Health Survey, 2016). This implies that mothers’ education and knowledge levels have an impact on their choice to either seek health services or not. Previous studies indicate that the major reasons for home births are; financial limitations, poor geographic accessibility of health facilities in terms of transport and distance, lack of decision making power among the women, inability to afford the medical supplies that are often compulsory at public health facilities, bad attitudes of health workers, preference for traditional birth attendants, socio-cultural norms surrounding childbirth among others. Efforts are being made to improve the health service delivery and accessibility in Uganda (Ministry of Health, 2015), so that mothers receive help from skilled health care providers during birth of their children and shortly after, and therefore, reduce the high maternal and infant mortality rates. The maternal mortality rates in Uganda however remain high at 320 per 100,000 live births (World Health Organisation, 2015) in comparison to the country’s targeted 131 per 100,000 live births by 2015 (Uganda Bureau of x Statistics, 2016), and the infant mortality rate is at 53 infant deaths per 1,000 live births, compared to the targeted 51 deaths per 1,000 live births, (Ministry of Health, 2015/15 - 2019/20). This therefore brings about questions as to why this is rampant in these regions, even with the continued efforts to improve health service delivery systems.