Mainstreaming nutrition in maternal, newborn and child health: barriers to seeking services from existing maternal, newborn, child health programmes

Table of Contents Summary 237 Introduction 238 Objectives 238 Approach and methodology for the study 238 Background to barriers to use of health services 239 Models of health service utilization 239 Mosley and Chen Child Survival framework 239 Explanatory models 239 Hierarchy of resort 240 Dimensions of access 240 Framework for categorization of barriers 241 Summary 242 Barriers to use of health services 242 Geographic access 243 Temporal access 244 Socio‐cultural access 245 Financial access 248 Quality of care 249 Discussion 250 References 252 Summary In the light of mainstreaming nutrition programs into health services, this review article approaches the issue of barriers to existing maternal child health programs from both theoretical and applied perspectives. It begins with a discussion of salient literature on models of health service utilization. The mid‐section of the paper presents the results of a review of research studies that illuminate the barriers to care. Categorical themes emerged from the review of studies in the form of barriers based on geographic factors, temporal factors, a myriad of socio‐cultural factors, financial factors and quality of care. The discussion focuses on the need to overcome existing restrictions to health services in order to facilitate initiatives to mainstream nutrition and achieve Millennium Development Goal #1.