Overcoming Access Barriers for Facility-Based Delivery in Low-Income Settings: Insights from Bangladesh and Uganda (Report‪)‬

INTRODUCTION Increasing the proportion of women who deliver in a health facility can be an important means in reducing maternal mortality in low-income settings. It is globally recognized that one of the main challenges to achieving the Millennium Development Goal (MDG) of a global reduction of maternal death by 75% by 2015 (1) is the low proportion of women who deliver with a skilled birth attendant (2). Deliveries in health facilities can ensure that women are attended by skilled personnel and also link women to the referral system in the case of any complications. In many low-income settings with a high burden of maternal deaths, few women use facilities for birth, often choosing a higher-risk birth at home, often without professional medical assistance. Past studies have identified several reasons why women or families may choose home-delivery as a preferred option and a number of access barriers to using facilities as well. In all countries, there are some women who choose to deliver in health facilities and who are seemingly able to overcome the known access barriers.