“I Have Missed Three Moons: What Should I Do Now?” A Pregnant Mother In The Baloch Community, Balochistan, Pakistan

Abstract

Health indicators related to maternal health in Balochistan Province are poor as compare to other provinces along with low utilization of maternal health services. Majority of Balochistan province is rural and people are still living in tribal based communities where males play a dominant role with low autonomy of women. The purpose of the study was to describe the pattern of antenatal care (ANC) seeking from private and government health services and local cultural ANC services and barriers toward ANC in the Baloch community. The study was conducted in 2011 at district Jhal Magsi, Balochistan province, Pakistan. The data was collected through observations, focus group discussions n= 08 (pregnant mothers, n= 04 married men, n= 04) and in-depth interviews were conducted among health care providers (doctors n= 03, LHVs, n= 03, Health Technicians/ unregistered practitioners, n= 05) local folk healers/Traditional birth attendants (TBA), n= 05 and tribal elders, n= 02. The data was transcribed, coded and analyzed through constant comparison analysis method. The results of the study revealed that during normal circumstances antenatal care seeking was not a common practice and depended on the decision of the male and severity of the problem during pregnancy. The determinants of ANC in the rural Baloch communities include low awareness of antenatal care, women autonomy, polygyny, feudal anarchies, religious factors, availability of health facilities, health staff especially availability of female staff, past experiences of men and direct or indirect financial costs. In conclusion, results of the study revealed that routine antenatal care seeking among women in Baloch community is low and is dependent on male and family decision. Involving male in maternal health issues and increasing number of female staff and approaching pregnant women in the community may ultimately contribute to create a maternal healthcare system in Balochistan province reflecting an increased efficiency, more equity and good governance to improve maternal health.