Date of Conferral

2016

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Nancy Moss

Abstract

Haiti is a Caribbean island with a humanitarian medical center providing healthcare services to 90,000 residents. Pregnant women visiting the medical clinic for prenatal care often do not return for delivery; instead, they return home to deliver alone or with the assistance of a traditional matron. Home-birth practices increase maternal-child health morbidity and mortality in an already fragile country. The purpose of this project was to gain a deeper understanding of Haitian pregnant women's preferences to deliver at home or at the healthcare clinic. The transtheoretical model for behavior change and the Johns Hopkins nursing evidence-based practice model guided the project. Two focus groups of 10 pregnant women total were recruited in the community of Delmas 32, Haiti. Group 1 was comprised of 5 women who delivered at home with matrons and Group 2 was comprised of 5 women who delivered at the clinic. Structured questions were asked to identify themes related to delivery location preferences. Focus group transcripts were analyzed guided by the Krueger and Casey strategy model. The thematic analysis was aligned with the peer-reviewed literature. Findings revealed that lack of access to care, lack of education and sensitization, and the attitude of healthcare personnel impacted women's preference for delivery at the clinic. Findings also supported a need to educate staff and the community in the best options for maternal-child care. A workshop was developed, based on the project findings, to share the recommendations with the clinic staff. The clinical leadership have indicated that they will implement the project recommendations. This project has the potential to support social change by reducing maternal-child deaths in Delmas 32 and across the Caribbean.

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