Examining the roles of significant others of women in the uptake of health facility delivery in Northern Uganda: perspectives from the health belief model.

Abstract Background: Health facility delivery improves maternal and child health outcomes but has not been fully achieved in countries with the poorest maternal health indicators. We identified and examined the roles of key influencers (significant others) of mother’s perceptions towards health facility delivery in Northern Uganda. Methods: This was an exploratory study conducted using in-depth interviews with eleven significant others in a mother’s life; who were purposively selected from four sub-counties of; Ogur, Agweng, Amach and Agali, as part of a larger study in Lira district, Northern Uganda. We also conducted seven key informant interviews with health workers involved in maternal and child health care. Data analysis using Atlas ti version.7.0 was conducted deductively following a thematic framework approach to analyse themes adapted from the health belief model. Results: The study identified husbands, biological mothers, mothers-in-law, fathers-in-law, brothers and co-wives as influencers of mother’s perceptions on uptake of health facility delivery. Other significant others included traditional birth attendants who were believed to have the ability to determine when the condition of a mother required the intervention of a medical expert. Community members such as local village leaders, village health extension workers and neighbours were also cited . Whereas husbands were regarded as ke y significant others of women, health workers emphasized that, husbands were not always available to support the mothers during pregnancy and child birth. The roles of significant others of women included: planning for birth, providing financial support, making decisions on where a mother will deliver from, continued counselling and psychosocial support. Conclusion: Programs aimed at increasing male involvement to improve maternal and child health outcomes should also target other influencers of women’s perceptions on health facility delivery including family and community members, to provide back-up support to mothers in the absence of their husbands.