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Cited by 27Global Maternal and Child HealthPublic Health and Social InequalitiesMaternal and Perinatal Health Interventions

Access barriers to maternal healthcare services in selected hard-to-reach areas of Zambia: a mixed methods design

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Mweemba, Chris, Mapulanga, Miriam, Jacobs, Choolwe, Katowa-Mukwato, Patricia, Maimbolwa, Margaret·2021·Pan African Medical Journal
DOI 10.11604/pamj.2021.40.4.28423PMC PMC8490167
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Abstract

INTRODUCTION: poor access to maternal health services is a one of the major contributing factors to maternal deaths in low-resource settings, and understanding access barriers to maternal services is an important step for targeting interventions aimed at promoting institutional delivery and improving maternal health. This study explored access barriers to maternal and antenatal services in Kaputa and Ngabwe; two of Zambia´s rural and hard-to-reach districts. METHODS: a concurrent mixed methods approach was therefore, undertaken to exploring three access dimensions, namely availability, affordability and acceptability, in the two districts. Structured interviews were conducted among 190 eligible women in both districts, while key informant interviews, in-depth interviews and focus group discussions were conducted for the qualitative component. RESULTS: the study found that respondents were happy with facilities´ opening and closing times in both districts. By comparison, however, women in Ngabwe spent significantly more time traveling to facilities than those in Kaputa, with bad roads and transport challenges cited as factors affecting service use. The requirement to have a traditional birth attendant (TBA) accompany a woman when going to deliver from the facility, and paying these TBAs, was a notable access barrier. Generally, services seemed to be more acceptable in Kaputa than in Ngabwe, though both districts complained about long queues, being delivered by male health workers and having delivery rooms next to male wards. CONCLUSION: based on the indicators of access used in this study, maternal health services seemed to be more accessible in Kaputa compared to Ngabwe.

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  • The increase in maternal mortality rates could be linked to systemic issues such as fragmented delivery of healthcare, socioeconomic barriers limiting access to prenatal care, and challenges in managing preventable and treatable conditions like preeclampsia and hemorrhage.

    “The increase in maternal mortality rates could be linked to systemic issues such as the fragmented delivery of healthcare, socioeconomic barriers limiting access to prenatal care, and challenges in managing preventable and treatable conditions like preeclampsia and hemorrhage [23, 24].”

    From Age-related disparities in national maternal mortality trends: A population-based study (2025) · cites this paper as [24]

    The Introduction (page not provided) links maternal deaths in low-resource settings to weak health systems and poor access to care; the Discussion identifies transport and financial barriers to maternal services. The paper does not document an increase in maternal mortality rates or discuss difficulties managing preeclampsia or hemorrhage. (LLM, conf=0.86)

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Authors
Mweemba, C., Mapulanga, M., Jacobs, C., Katowa-Mukwato, P., & Maimbolwa, M.
Affiliations
  • University of Zambia (ZM)
  • University of Lusaka (ZM)
Corresponding author
Mweemba, Chris
ORCID
Venue
Pan African Medical Journal
Publisher
Pan African Medical Journal
Published
2021
Volume
40
Pages
4-4
ISSN
1937-8688 (ISSN-L)
DOI
10.11604/pamj.2021.40.4.28423
PMC
PMC8490167
OpenAlex
W3196396784
Cited by
27
References
2
Citations by year
2026: 5 · 2025: 9 · 2024: 5 · 2023: 6 · 2022: 2
FWCI
3.22
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Pan African Medical Journal (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Social Sciences › Health › Public Health and Social Inequalities
  • Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
Keywords
access barriers, obstetric care, prenatal care, institutional delivery, hard-to-reach areas, rural health, traditional birth attendants, service availability, service affordability, service acceptability, travel time, road infrastructure
MeSH terms
Maternal Health, Adolescent, Adult, Female, Health Services Accessibility, Humans, Interviews as Topic, Maternal Health Services, Middle Aged, Midwifery, Pregnancy, Prenatal Care, Rural Population, Socioeconomic Factors, Zambia, Focus Groups, Young Adult

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