SOCIO-ORGANIZATIONAL FACTORS OF REPRODUCTIVE HEALTH AND ACCESS TO OBSTETRIC CARE

Abstract

Reproductive health outcomes are strongly influenced by social context and the organization of health services, particularly in settings with marked rural–urban differences.To assess women’s awareness of reproductive health, reproductive attitudes, and socio-organizational barriers affecting access to and quality of obstetric care in Uzbekistan. A cross-sectional survey using a standardized questionnaire was conducted in 2025 among 5,000 women aged 15–49 years residing in different regions of the Republic of Uzbekistan. Data covered socio-demographic characteristics, fertility intentions, pregnancy planning practices, antenatal follow-up, and patient–provider communication. Most respondents were aged 20–34 years, reflecting peak reproductive age. A substantial proportion lived in rural areas (62.1%), highlighting potential geographic inequities in service access. While 62.5% reported current or future fertility intentions, only 39.2% discussed pregnancy planning with healthcare professionals. Antenatal follow-up was most commonly received in polyclinics (72.3%), with 12.4% using private clinics. Counseling on pregnancy danger signs was reported by 48.3%, whereas 32.1% stated it was not provided. Patient experience indicators suggested gaps in communication: 41.2% reported clear explanations, 61.8% reported respectful treatment, and only 35.4% were able to ask questions and receive detailed answers; 42.6% confirmed confidentiality of medical information.
The findings indicate persistent information deficits and service-quality gaps, particularly in counseling, patient engagement, and confidentiality, with rural residence potentially exacerbating barriers. Strengthening patient-centered communication, standardized counseling protocols, and targeted reproductive health education—especially in rural areas—may improve access and quality of obstetric care