Conflict and Health
Volume 5, Issue 1, 2011

Reproductive health for refugees by refugees in Guinea III: Maternal health (Article) (Open Access)

Howard N.* , Woodward A. , Souare Y. , Kollie S. , Blankhart D. , Von Roenne A. , Borchert M.
  • a London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, United Kingdom
  • b London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, United Kingdom
  • c Reproductive Health Group (RHG), Guéckédou, Guinea
  • d Reproductive Health Group (RHG), Guéckédou, Guinea
  • e Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH, 65726 Eschborn, Germany
  • f Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH, 65726 Eschborn, Germany
  • g Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Germany, Institute of Tropical Medicine, Antwerp, Belgium

Abstract

Background: Maternal mortality can be particularly high in conflict and chronic emergency settings, partly due to inaccessible maternal care. This paper examines associations of refugee-led health education, formal education, age, and parity on maternal knowledge, attitudes, and practices among reproductive-age women in refugee camps in Guinea. Methods. Data comes from a 1999 cross-sectional survey of 444 female refugees in 23 camps. Associations of reported maternal health outcomes with exposure to health education (exposed versus unexposed), formal education (none versus some), age (adolescent versus adult), or parity (nulliparous, parous, grand multiparous), were analysed using logistic regression. Results: No significant differences were found in maternal knowledge or attitudes. Virtually all respondents said pregnant women should attend antenatal care and knew the importance of tetanus vaccination. Most recognised abdominal pain (75%) and headaches (24%) as maternal danger signs and recommended facility attendance for danger signs. Most had last delivered at a facility (67%), mainly for safety reasons (99%). Higher odds of facility delivery were found for those exposed to RHG health education (adjusted odds ratio 2.03, 95%CI 1.23-3.01), formally educated (adjusted OR 1.93, 95%CI 1.05-3.92), or grand multipara (adjusted OR 2.13, 95%CI 1.21-3.75). Main reasons for delivering at home were distance to a facility (94%) and privacy (55%). Conclusions: Refugee-led maternal health education appeared to increase facility delivery for these refugee women. Improved knowledge of danger signs and the importance of skilled birth attendance, while vital, may be less important in chronic emergency settings than improving facility access where quality of care is acceptable. © 2011 Howard et al; licensee BioMed Central Ltd.

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Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-79958274040&doi=10.1186%2f1752-1505-5-5&partnerID=40&md5=116dc1033eca349810e16abcf45c4cd7
DOI: 10.1186/1752-1505-5-5
ISSN: 17521505
Cited by: 6
Original Language: English