Barreras para el acceso a salud reproductiva enfrentadas por mujeres que residieron en la Provincia del Azuay y que fallecieron por causas maternas durante el año 2017

Abstract

The Sustainable Development Objectives include in its goals the decrease of maternal mortality rates. During the year 2017, Ecuador registers 211 maternal deaths, even though in 2018 they decreased to 154, the year 2019 shows a tendency to an increase in deaths. Objective: Identify the barriers to health service access that are faced by women, residing in the Azuay province, who died due to maternal causes in 2017. Methods: This is a mixed study: quantitative descriptive centered around nine cases of maternal deaths, and qualitative that retraces six interviews appertaining to each case. The analysis was executed with the statistics program SPSS and ATLAS.ti respectively. Conclusions: A risk profile made specifically for maternal mortality doesn't exist in terms of sociodemographic characteristics and those pertaining to reproductive health, although all women in this study who died due to this cause coincide in their complete lack of pregnancy planning. The Three Delay Model structured around emergency, proves to be insufficient for the purpose of an integral approach to the problematic, which is why a new proposal develops, "The Barriers, Delays and Four Moments Model" that mainstreams the gender perspective and analyzes maternal mortality as an effect of delays in the promotion of sexual and reproductive health, pregnancy prevention, health control and the moment during an emergency. There exist barriers related to gender, culture, economy, geography, as well as structural pertaining to the legal and sanitary system.