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Table 4 Facilitators of and barriers to institutional delivery

From: Barriers and facilitators to institutional delivery in rural areas of Chitwan district, Nepal: a qualitative study

Themes

Sub-themes

Facilitators

Barriers

Socio-cultural norms and values

Traditional care during birth and the post-partum period

• Institutional delivery in case of complications

• Childbirth as a normal life event

• Care by family members, neighbours and TBAs

• Freedom of movement during birth

• Warm environment after birth

• Food choices and practices

 

Family hierarchy and social norms

• Husbands and parents-in-law supportive of institutional delivery

• Shyness

• Low caste, poor education, early marriage

• Husbands and parents-in-law not supportive of institutional delivery

Access to birthing facilities

 

• Ambulance available

• Birthing centre nearby

• Sufficient financial incentives

• Material incentives: clothes for mother and baby

• Lack of roads (hill areas) or good roads

• Distance from health institution (especially in hill areas)

• Ambulance not always available

• Insufficient incentives

Perceptions regarding the quality of health services

 

• 24-h availability of midwives

• Friendliness of health workers

• Perceived incompetence of midwives

• Young age of midwives

• Poor infrastructure and lack of equipment at birthing centres

• Low budget allocated to birthing centres

  1. TBA Traditional birth attendant