Background: Despite Malawi government�s policy to support women to deliver in health facilities with the\r\nassistance of skilled attendants, some women do not access this care.\r\nObjective: The study explores the reasons why women delivered at home without skilled attendance despite\r\nreceiving antenatal care at a health centre and their perceptions of perinatal care.\r\nMethods: A descriptive study design with qualitative data collection and analysis methods. Data were collected\r\nthrough face-to-face in-depth interviews using a semi- structured interview guide that collected information on\r\nwomen�s perception on perinatal care. A total of 12 in- depth interviews were conducted with women that had\r\ndelivered at home in the period December 2010 to March 2011. The women were asked how they perceived the\r\ncare they received from health workers before, during, and after delivery. Data were manually analyzed using\r\nthematic analysis.\r\nResults: Onset of labor at night, rainy season, rapid labor, socio-cultural factors and health workers� attitudes were\r\nrelated to the women delivering at home. The participants were assisted in the delivery by traditional birth\r\nattendants, relatives or neighbors. Two women delivered alone. Most women went to the health facility the same\r\nday after delivery.\r\nConclusions: This study reveals beliefs about labor and delivery that need to be addressed through provision of\r\nappropriate perinatal information to raise community awareness. Even though, it is not easy to change cultural\r\nbeliefs to convince women to use health facilities for deliveries. There is a need for further exploration of barriers\r\nthat prevent women from accessing health care for better understanding and subsequently identification of\r\noptimal solutions with involvement of the communities themselves.
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