Structural barriers to maternity care in Cameroon: a qualitative study.

Publisher: BioMed Central Country of Publication: England NLM ID: 101224380 Publication Model: Electronic Cited Medium: Internet ISSN: 1742-4755 (Electronic) Linking ISSN: 17424755 NLM ISO Abbreviation: Reprod Health Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2004-

Maternal Health Services*/standards ; Qualitative Research* ; Health Services Accessibility*; Humans ; Cameroon ; Female ; Pregnancy ; Adult ; Maternal Mortality ; Focus Groups ; Health Personnel/psychology

Background: The maternal mortality and perinatal mortality rate in Cameroon are among the highest worldwide. To improve these outcomes, we conducted a formative qualitative assessment to inform the adaptation of a mobile provider-to-provider intervention in Cameroon. We explored the complex interplay of structural barriers on maternity care in this low-resourced nation. The study aimed to identify structural barriers to maternal care during the early adaptation of the mobile Medical Information Service via Telephone (mMIST) program in Cameroon.
Methods: We conducted in-depth interviews and focus groups with 56 key stakeholders including previously and currently pregnant women, primary healthcare providers, administrators, and representatives of the Ministry of Health, recruited by purposive sampling. Thematic coding and analysis via modified grounded theory approach were conducted using NVivo12 software.
Results: Three main structural barriers emerged: (1) civil unrest (conflict between Ambazonian militant groups and the Cameroonian government in the Northwest), (2) limitations of the healthcare system, (3) inadequate physical infrastructure. Civil unrest impacted personal security, transportation safety, and disrupted medical transport system. Limitations of healthcare system involved critical shortages of skilled personnel and medical equipment, low commitment to evidence-based care, poor reputation, ineffective health system communication, incentives affecting care, and inadequate data collection. Inadequate physical infrastructure included frequent power outages and geographic distribution of healthcare facilities leading to logistical challenges.
Conclusion: Dynamic inter-relations among structural level factors create barriers to maternity care in Cameroon. Implementation of policies and intervention programs addressing structural barriers are necessary to facilitate timely access and utilization of high-quality maternity care.
(© 2024. The Author(s).)

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K01 MH116737 United States MH NIMH NIH HHS; R21 HD103061 United States HD NICHD NIH HHS; R21HD103061 United States NH NIH HHS; K01MH116737 United States MH NIMH NIH HHS

Keywords: Cameroonian Women; Childbirth Care; Focus Group Discussions; Maternal health; Qualitative study

Date Created: 20240719 Date Completed: 20240719 Latest Revision: 20240725

20240726

PMC11264682

10.1186/s12978-024-01834-w

39030544