Due to its fragile health system and a combination of sociocultural, economic and political factors, South Sudan has some of the world’s worst health indicators. The aim of this study was to identify barriers impeding women’s use of institutional childbirth services in health facilities in the country’s Rumbek North County.
Data were collected from 14 focus groups involving 169 women and 45 men, as well as 18 interviews with key informants including community leaders, workers in local health facilities, traditional birth attendants and the staff of the county health department.
Four main categories of barriers were found:
- Problems related to access to and lack of resources (difficulty in getting to far-off healthcare facilities, lack of means of transport, travel made impracticable by flooding, inability to pay delivery service fees).
- Issues related to sociocultural factors and the backdrop of conflict in the country.
- Women’s perception of pregnancy and childbirth (lack of familiarity with the benefits of institutional childbirth, a perception of childbirth as low-risk event).
- Perception of the quality of health care.
Some of these factors are outside the scope of the health sector, thereby necessitating a multi-sectoral approach to ensure women’s access to safe childbirth services, and to support them throughout the full cycle of pregnancy and childbirth.