STUDY OBJECTIVE: To understand community based or socio-cultural factors that determine maternal morbidity and mortality in a semi-urban setting. DESIGN: The study is an exploratory multidisciplinary operations research and the instruments were focus groups and interviews. SETTING: Ekpoma, a semi-urban community with a population of 70,000 in central part of Edo state in southern Nigeria. PARTICIPANTS: Thirteen groups of women, two groups of men, and two groups of traditional birth attendants. RESULTS: There is a fairly good knowledge of haemorrhage but this is circumscibed by attitudes, practices, and situations that keep women away from or delay the decision to seek modern obstetric care. CONCLUSIONS: For a fuller understanding of maternal morbidity and mortality, it is important to consider factors outside the hospital and formal medical practice. Furthermore, a change of existing knowledge, attitudes, practices, and situations can be enhanced through modelling on them.
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