“God gives the child”: An abductive analysis of barriers to postnatal care using the Health Equity Implementation Framework
Year: 2026
Type: article
Abstract: BACKGROUND: Postnatal care (PNC) is recommended as a means of preventing maternal mortality during the postpartum period, but many women in low- and middle-income countries do not access care during this period. OBJECTIVE: We set out to examine sociocultural preferences that have been portrayed as barriers to care. DESIGN: We designed a qualitative study using the Health Equity Implementation Framework (HEIF). METHODS: We performed an abductive analysis of 63 semi-structured interviews with women who had recently given birth in three regions of Ethiopia using the HEIF and an inductive-deductive codebook to understand why women in Ethiopia do not use recommended PNC. RESULTS: We found that, in many cases, health providers do not consider women's cultural safety a primary need, but rather as a barrier to care. However, women's perceived refusal to participate in postnatal visits was, for many, an expression of agency and assertion of their needs for cultural safety. CONCLUSION: We propose adding cultural safety to HEIF as a process outcome so that implementers consider cultural needs in a dynamic manner that does not ask patients to choose between meeting their cultural needs and receiving necessary health care during the postnatal period.
Source: Women s Health
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,000
Funders: Korea Medical Institute, Deanship of Scientific Research, King Khalid University, Bill and Melinda Gates Foundation, Children's Hospital of Philadelphia, North Carolina State University, Helsingin Yliopisto, Medicinska Understödsföreningen Liv och Hälsa, Wellcome Trust, Department for Business, Energy and Industrial Strategy, UK Government, Open Philanthropy Project, Folkhälsanin Tutkimussäätiö, Office of the Royal Development Projects Board, Munuaissäätiö, Multiple Sclerosis Society of Canada, British Heart Foundation, Academy of Medical Sciences, Loughborough University, University of Auckland, Deutsche Forschungsgemeinschaft, Agence Nationale de la Recherche, National Natural Science Foundation of China, Ministerstvo Školství, Mládeže a Tělovýchovy, Grantová Agentura České Republiky, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Austrian Science Fund, Chiang Mai University, Chulalongkorn University, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Korea Health Industry Development Institute, National Research Foundation of Korea, Hjärnfonden, Javna Agencija za Raziskovalno Dejavnost RS, Türkiye Bilimsel ve Teknolojik Araştırma Kurumu, Lietuvos Mokslo Taryba, Fundação de Amparo à Pesquisa do Estado de Minas Gerais, Göteborgs Läkaresällskap, National Taiwan University Hospital, Sigrid Juséliuksen Säätiö, Medicinska Forskningsrådet, Novo Nordisk Fonden, Army Medical University, European Agricultural Fund for Rural Development, Eva Mayr-Stihl Stiftung, National Institutes of Health, Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, Engineering and Physical Sciences Research Council, Biotechnology and Biological Sciences Research Council, Natural Environment Research Council, Japan Society for the Promotion of Science, National Key Research and Development Program of China, NIHR Leicester Biomedical Research Centre, National Institute on Alcohol Abuse and Alcoholism, National Heart, Lung, and Blood Institute, National Institute of Allergy and Infectious Diseases, National Institute of Neurological Disorders and Stroke, National Institute of Child Health and Human Development, Division of Biological Infrastructure, Biosense Webster, Air Force Office of Scientific Research, H2020 European Research Council, Key Research and Development Program of Zhejiang Province
OpenAlex ID: W7151054218