Can she make it? Transportation barriers to accessing maternal and child health care services in rural Ghana

Abstract

BackgroundThe Ghana Community based Health Planning and Services (CHPS) strategy targets to bring health services to the doorsteps of clients in a manner that improves maternal and child health outcomes. In this strategy, referral is an important component but it is threatened in a rural context where transportation service is a problem. Few studies have examined perceptions of rural dwellers on transportation challenges in accessing maternal health care services within CHPS.MethodsUsing the political ecology of health framework, this paper investigates transportation barriers in health access in a rural context based on perceived cause, coping mechanisms and strategies for a sustainable transportation system. Eight (8) focus group discussions involving males (n = 40) and females (n = 45) in rural communities in a CHPS zone in the Upper West Region of Ghana were conducted between September and December 2013.ResultsLack of vehicular transport is suppressing the potential positive impact of CHPS on maternal and child health. Consistent neglect of road infrastructural development and endemic poverty in the study area makes provision of alternative transport services for health care difficult. As a result, pregnant women use risky methods such as bicycle/tricycle/motorbikes to access obstetric health care services, and some turn to traditional medicines and traditional birth attendants for maternal health care services.ConclusionThese findings underscore the need for policy to address rural transport problems in order to improve maternal health. Community based transport strategy with CHPS is proposed to improve adherence to referral and access to emergency obstetric services.

Qualitative Assessment of the Feasibility, Usability, and Acceptability of a Mobile Client Data App for Community-Based Maternal, Neonatal, and Child Care in Rural Ghana

“…The health centers are staffed primarily by skilled health professionals (such as nurses and midwives) who offer comprehensive preventive and basic curative services, including minor surgeries and uncomplicated deliveries. In contrast, as part of Ghana's Community-based Health Planning and Services (CHPS) Initiative, community health posts are staffed by lower-skilled CHNs who provide health education, outreach and counseling, and basic curative services to clients via home visits and facility-based care [47]. Community health posts (referred to locally as CHPS facilities) are typically staffed by 2 to 3 CHNs who are required to have completed a two-year postsecondary certificate program in obstetrics as well as general and community health nursing.…”

Predictors of Neonatal Deaths in Ashanti Region of Ghana: A Cross-Sectional Study

“…Some simply lack confidence in the health system. Difficult geographic terrain and limited transportation may present obstacles to reaching a skilled attendant [12,13].…”

“…Children delivered at home are likely to experience higher mortality than children delivered at the hospital or medical facilities because these facilities usually provide a sanitary environment and medical equipment to assist birth. However, home deliveries without a skilled attendant are chosen or occur for a variety of reasons, including long distances or difficult access to a birth facility, costs of services, and perceived lack of quality of care in a health facility [12,28].…”

Timing and utilization of antenatal care services in Liberia: Understanding the pre-Ebola epidemic context

“…Other factors such as birth-parity and marital status, individual characteristics such as mothers' education, and also religion have been shown to influence the utilization of maternal health care services (Rishworth et al, 2016;Atuoye et al, 2015;AbouZahr and Wardlaw, 2003;Chakraborty et al, 2003). In particular, education provides women with autonomy in decision making, and has been identified to have the greatest impact on reproductive behaviours (Monden and Smits, 2012;Jejeebhoy, 1995).…”