Paper short abstract:

On the basis of experience with the Safe Motherhood Program, the present study uses a health and ethnographic approach to analyze the factors that affect the choices and often tortuos path, arising from obstetric complications.

Paper long abstract:

The lack of access of women to Sexual Reproductive Health services, particularly in developing countries, contributes to the high morbidity and mortality arising from health problems that should be largely avoidable. So, at the Millennium Development Goals, "universal access" become a target to improve maternal health by 2015

Access represents the posibility to obtain reproductive health care when required. Consequently, this implies a dialectic between the supply of and the potential demand. Due to this dialectic, the pregnant woman and her cultural context becomes a key dimension, whose study and analysis are generally ignored in public health policies.

On the basis of experience with the Safe Motherhood Program in southern Mozambique, the present study uses a health and ethnographic approach to analyze the factors that affect the choices and often tortuos path, arising from obstetric complications in a society where biomedicine coexist with other medical sistems. Those choices and courses do derive not merely from kinship and gender relations and the cultural logic about maternity, disease, risks and causality but also from the socialization of experiences that individuals have with the health services. Conditioned by the context of poverty, the health system offers a fragile alternative for responding to the population's medical needs "when required". In this scenario, where access has health and cultural dimensions, the present study about access analyzes the "meetings and misses" between the health services and the population and furnishes a basis for a qualitative interpretation of the reproductive health indicators.