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Strategies applied by women in coping with ad-hoc demands for unauthorized user fees during pregnancy and childbirth. A focus group study from Angola.
Lund University, Sweden; Karolinska Institutet, Sweden.
Karolinska Institutet, Solna, Sweden .
Midwifery School, Luanda, Angola.
Karolinska Institutet, Sweden.
2007 (English)In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 28, no 3, 224-246 p.Article in journal (Refereed) Published
Abstract [en]

Our aim in this study was to explore women's responses to reported ad-hoc demands for unauthorized user fees during pregnancy and childbirth in Luanda, Angola. Ten focus group discussions were conducted and data were analysed using grounded theory. Women were found to apply six strategies as they "endeavored to cope with demands for unauthorized user fees" (core category): (i) blowing the whistle, (ii) searching for comprehension, (iii) manipulating the system, (iv) bargaining, (v) extending the limits, and (vi) balancing. The system of unauthorized user fees appears to be a symptom of a deeper structural problem, which requires multifaceted and long-term interventions such as insti-tutional reforms and clear policies on accountability and transparency. Better resource availability for the MHC sector is required in order to secure adequate salaries to maternal health care providers. The fact that unethical behavior is unveiled implies that interventions also need to target the national midwifery training.

Place, publisher, year, edition, pages
2007. Vol. 28, no 3, 224-246 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-11125DOI: 10.1080/07399330601179885PubMedID: 17364983Scopus ID: 2-s2.0-33847008641OAI: oai:DiVA.org:mdh-11125DiVA: diva2:370759
Available from: 2010-11-17 Created: 2010-11-17 Last updated: 2015-06-01Bibliographically approved

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CiteExportLink to record
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Citation style
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