Qualitative study on maternal referrals in rural Tanzania: Decision making and acceptance of referral advice

The aim of this study was to describe perceptions of maternal referrals in a rural district in Tanzania. Focus group discussions (FGDs) with health workers and community members, stratified by age and gender, were conducted. The FGDs revealed that husbands and relatives are the decision makers in maternal referrals, whereas the women had limited influence, especially on emergency referrals. The process in deciding to seek referral care is envisaged within community perception of seriousness of the condition, difficulty to access and cost involved in transport, living expenses at the hospital, and perceived quality of care at facility level. The hospitals were seen as providing acceptable quality of care, whereas, the health centres had lower quality than expected. To improve maternal referral compliance and reduce perinatal and maternal morbidity and mortality, community views of existing referral guidelines, poverty reduction, women's empowerment and male involvement in maternal care are necessary. (Afr J Reprod Health 2008; 12[2]:120-131)

Perceptions of women about menstrual regulation services: qualitative interviews from selected urban areas of Dhaka.

Menstrual regulation (MR) programmes were introduced in Bangladesh in 1974 to reduce morbidity and mortality due to unsafe abortions. About 468,000 MR procedures are performed annually, and its potential is not fully used. To develop MR programmes, the voices of women could add important aspects to its acceptability. This qualitative interview study aimed to explore and describe the perceptions about MR in a sample of women from Dhaka, Bangladesh. The most prominent perception was that, despite the moral dilemma inherent in terminating pregnancies, MR was highly valued as a solution in problematic life situations. However, unprofessional attitudes and misconduct among MR providers were revealed, and there was also a lack of knowledge and openness in families. To improve the quality of MR services, professional ethics needs to be highlighted in training and supervision of providers. To improve the acceptability of MR, education on the benefits of MR has to be made available to the whole population.