Why women deliver at home
Purpose of Production:
participatory video used to determine why some women deliver at home in Zaka District, Masvingo Province, Zimbabwe
This activity was conducted by Africa Women Filmmakers Trust in partnership with SolidarMed Zimbabwe and in collaboration with the Ministry of Health and Child Care. The activity sought to determine the causes why some women still deliver at home in Zaka District, Masvingo Province. Home deliveries still take place in spite of efforts by government to ensure that every child is delivered at a health facility. The aim by government is to improve maternal health and child mortality in the district.
The use of the participatory video production process as a tool to gather data was very effective as it generated a sense of empowerment among the participants. They became aware that their voices and concerns would be heard beyond their perceived boundaries. The input from the participants can help to improve policy and decisions in the field of maternal health.
The participatory video production process encouraged public community dialogues and community conversations focusing on cultural, social, economic, religious and service provider factors that influence women to deliver at home.
During this activity AWFT had focus group discussions and interviews with community members and health care professionals at district, provincial and national level. Activities took place at selected sides scattered over Zaka district to obtain a representative picture. The major factors that cause women and girls to deliver at home were analyzed using the three-delay model.
Dis-respectful attitudes of health care workers, user fees at hospitals as well as indirect costs of institutional delivery, limited birth preparedness and poor health knowledge, male based decision making, and HIV testing at health facilities were often mentioned as causes why women decide to deliver at home.
Difficulties reaching a health facility were also frequently mentioned by community members as well as health care professionals. Distance from home to a health facility is often a major obstacle especially during the night. The small number of ambulances and private cars available for referring patients as well as the costs for transport are a challenge. Some people also mention the lack of available maternity waiting homes at some facilities or the poor condition of these structures.
Perceived poor quality of care in terms of disrespectful care and negligence was a major complaint of community members. Many women experienced the healthcare professionals as rude and immoral. Lack of adequate resources like medical equipment, essential medication as well as poorly applied knowledge by health care professionals was mentioned.