Cookies on this website

We use cookies to ensure that we give you the best experience on our website. If you click 'Accept all cookies' we'll assume that you are happy to receive all cookies and you won't see this message again. If you click 'Reject all non-essential cookies' only necessary cookies providing core functionality such as security, network management, and accessibility will be enabled. Click 'Find out more' for information on how to change your cookie settings.

BACKGROUND: The maternal mortality ratio in Sub-Saharan Africa remains high, despite progress in reducing maternal mortality in other parts of the world. OBJECTIVE: To explore the perceptions of women and communities to identify barriers to the uptake of obstetric services. SEARCH STRATEGY: A systematic review of qualitative studies exploring perceptions of pregnancy and obstetric services, with thematic synthesis of the included studies. SELECTION CRITERIA: Qualitative studies reporting findings from focus group discussions and in-depth interviews between 1996 and 2009 were included. DATA COLLECTION AND ANALYSIS: Thematic synthesis involved collating and reviewing quotations taken directly from included studies. Themes were generated and clustered for analysis. MAIN RESULTS: Twenty-seven studies were included and 6 major themes identified: perceptions of healthcare workers; perceptions of the hospital environment; cultural perceptions of women; cultural perceptions of pregnancy; perceptions of traditional birth attendants and traditional healers; and role of the community in pregnancy and birth. CONCLUSION: Community attitudes regarding cultural beliefs and interactions with healthcare providers were identified as barriers to the utilization of healthcare services during pregnancy in Sub-Saharan Africa. These prevent engagement with prenatal care and timely use of medical services. Addressing the barriers will be seminal to the success of any healthcare intervention.

Original publication




Journal article


Int j gynaecol obstet

Publication Date





224 - 227


Africa South of the Sahara, Culture, Female, Health Knowledge, Attitudes, Practice, Humans, Maternal Health Services, Pregnancy, Prenatal Care, Residence Characteristics