Objectives: The purpose of this study was to examine rural women s access to
maternal health information and its impact on levels of skilled healthcare utilization.
Method: A qualitative study involving twenty five (25) pregnant women,five (5)
Skilled healthcare providers and five (5) Traditional Birth Attendants (TBAs) was
conducted in Chamwino District in Dodoma Region, Tanzania for a period of six
months. Due to time and resource limitation the researcher selected two (2) of the 32
wards in the district where the problem of maternal mortality and non-utilization of
skilled healthcare was most prominent. The two selected wards were Msanga and
The researcher used The Health Belief Model and Theory of Planned Behaviour to
develop interview questions and focus group guides as well as the interpretation of the
findings. The researcher examined how variable factors e.g. maternal health literacy,
individual perceptions, local knowledge and care provider-related factors affect
pregnant women s health behaviours and utilization of skilled maternal services. The
Data was analysed thematically using the 6-stage guide to thematic data analysis with
the help of NVIvo Software.
Results: The inadequate conditions of the health facilities and the poor working
conditions of the care providers affected the provision of quality of maternal services
and health information to pregnant women in the study area. The limited access to
skilled maternal health information from skilled healthcare providers and lack of
alternative sources of reliable health information led pregnant women to seek health
information from their Mothers-in-laws, TBAs and other women in the
society. However, there was a shortcoming of information inaccuracy as their health
advice was not based on previous expert advice but rather on the personal opinion and
attitude towards skilled maternal services.
The limited access to maternal health information caused majority of pregnant women
to underestimate the risks of pregnancy related complications and how they responded
to pregnancy danger signs and other ill-health conditions that raised during
pregnancy. The majority of pregnant women reported not to seek and kind of care
when experienced a health problem. It was also found that during labour some would
go to the TBA for childbirth and later go to the dispensary when the TBA failed while
others would just go for TBAs opinion and confirmation that it was real labour then go
to the health facility. This delayed women s timely access to obstetric care which is
essential for positive outcome when a pregnant woman experiences a pregnancy or
Conclusion: The improvement of the quality of skilled healthcare services in rural
areas is a prerequisite for achieving desired outcomes in maternal mortality reduction
efforts in Tanzania. However, improvement of quality itself is not a panacea if
pregnant women are not aware of the services, hence the healthcare providers should
also focus in increasing provision of maternal health information to pregnant women.
The findings show that the limited access to skilled maternal health information from
healthcare providers and lack of alternative sources for reliable health information has
constrained majority of these women from becoming maternal health literate hence
affecting their levels of utilization of skilled maternal services. The healthcare
providers and policy makers should focus on meeting the health information needs of
general rural populations and enable them to become well-informed and
knowledgeable to make better and well-informed maternal health decisions.
A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of Doctor of Philosophy of Loughborough University.