There has been progress in Ethiopia, and the government is to be commended for establishing a policy to provide free delivery services for all women. Many of the facilities that IntraHealth supports deliver more babies than the national average for health facilities but still lag behind where we would like to see them. The purpose of our gender assessment was to identify why more women do not give birth in health facilities. We carried out 25 focus group discussions in two regions and six sites with female and male health service and non-service users, as well as with providers and local religious leaders.
So why, despite the risks of home birth and the benefits of institutional delivery, are most women in Ethiopia still giving birth at home?
Across the board, the number-one barrier identified by all of the focus groups was disrespect and abuse of pregnant women in health facilities. Or, more accurately, gender-based violence against pregnant women in health facilities (more on that later). Group members mentioned this barrier far more often than either geographic or financial barriers.