Imran Inayat Yousafzai, Gulrukh Mehboob, Siham Sikander, Iffat Rubab.
Factors responsible for not utilizing institutional delivery services in Khyber Agency FATA, Pakistan.
Pak J Public Health Jan ;2(4):20-4.

Background: Literature from Pakistan suggests that lack of access and utilization to healthcare is a serious public health concern linked directly to maternal mortality and morbidity. This study provides a brief overview of the factors responsible for not utilizing institutional deliveries in Khyber agency Federal Administered Tribal Areas (FATA). Methods: A descriptive cross sectional study design was adopted by using simple random sampling technique. Women of age 15-49 years who delivered at home during the last 6 months were considered for analysis. Data collection was done through pre-tested semi-structured questionnaire after taking verbal consent from the respondents. Results: Results of the study revealed that the non-availability of 24/7 maternity services, cultural factors, cost and distance affects the utilization of maternity services especially the institutional delivery. Socio-Cultural factors like the issues of “privacy” were increasingly reported by women that affect the utilization of maternity services. It was also noted that large number of pregnant women does seek antenatal care but do not prefer institutional delivery. Health seeking behaviors was revealed to be influenced by the elders in the family i.e. mother in laws, friends or husband whereas women’s autonomy and decision making was reported very poor. Information related to delivery care was frequently taken from friends, family, health personnel or radio while interestingly most of women reported health personnel to be the most reliable source of information. Conclusions: It is concluded from the study that in general the utilization of the maternal health services are affected by many reasons including socio-economic, socio-cultural, distance and transportation, women autonomy and decision making. Traditional values like “privacy” were observed to be one of the major factors and hence steps should be taken to provide the maternal health services with keeping in mind the traditional values and norms of the area.

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