Human Resources for Health in Maternal, Neonatal and - HRH ...

(UNICEF 2007)
However, the road to death is a long one, and socio-cultural factors play an important role.
Examples of socio-cultural factors include early childbearing due to early marriage, lack of
access to contraceptives leading to too early or late childbearing, too many and too closelyspaced
births, and unwanted pregnancy; poor nutrition of girls and women, especially during
pregnancy and after childbirth; and low utilisation of health services due to limited decisionmaking
power, traditional beliefs about the causes of ill-health, and lack of knowledge about
service availability. Other factors include the generally lower educational attainment and low
social status of women as well as limited physical and financial access to health-care
services. Certain vulnerable groups such as religious, ethnic and linguistic minorities, people
affected by armed conflict and the very poor experience high maternal mortality and high
unmet need for reproductive health services.
Factors influencing MNRH and HRH at the community level
The ability of health workers to facilitate progress towards MNRH at community level is
affected by a complex interaction of factors, many of which are largely beyond their control
and include lack of political commitment and governance, government and donor funding
priorities, weak health systems, a lack of infrastructure at the community level, and sociocultural
factors that impact upon health seeking behaviour. These factors, outlined below in
Figure 8, are interrelated and affect the impact and sustainability of community health
programmes.
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