Pathways Utilized for Antenatal Health Seeking Among Women in the Ga East District, Ghana

Abstract

SUMMARYBackground: Ghana's maternal mortality ratio has been declining over the last two decades but at a rather slow pace. Poor access to effective maternity care is identified as one of the key challenges of maternity care. The current study mapped out the pathways to pregnancy care seeking among urban-dwelling adult women in a peri-urban district located in the Greater Accra region of Ghana. Methods: A total of 300 women who had a live birth in the last 12 months participated in a communitybased survey. They answered questions on care seeking behavior related to their last pregnancy. A multivariate Logistic regression model was used to identify factors associated with multiple care seeking behavior. Results: Almost all women in the survey (98%) reported accessing skilled antenatal care (ANC) from a biomedical provider, although 35% begun ANC later than the first trimester. About 45% of women simultaneously utilized both ANC and alternative care providers (ACP) including traditional birth attendants, herbalists, and spiritualists. A complex pathway to antenatal care seeking behavior involving shuttling between providers was observed. Controlling for household wealth, household size, and age, seeking care from multiple providers concurrently was associated with residence in Kwabenya sub-district OR=2.13 (95% CI: 1.28, 3.55) and previous abortion OR=2.08 (95% CI: 1.11, 3.91) Conclusions: Urban-dwelling women in Ga East District seek antenatal care concurrently from multiple sources. Health system interventions must seek ways to integrate alternative care providers into the existing biomedical health care system.

Strengthening the Referral System through Social Capital: A Qualitative Inquiry in Ghana

“…Apparently, such weak efforts underline the ‘ignorance’ [ 7 ] of the public regarding the policy. Nevertheless, the negative behaviours of participants regarding the adoption of the official referral pathway were similar to the findings from earlier works in Ghana [ 10 , 32 , 43 ]. Similar observations have also been made by studies in other sub-Saharan countries such as Uganda [ 11 ] and Nigeria [ 13 ].…”

“…Families, communities and peer-induced factors sometimes encourage people to skip or bypass lower level health services in favour of higher-level ones at the onset of a health problem [ 29 , 30 ]. Research in many parts of Ghana have consistently registered that reliance on both close and distant social networks—including cognitive elements such as trust—lead to adoption and conflation of different forms of health practice and options without recourse to the referral system [ 31 , 32 ]. Developments in other sub-Saharan African countries [ 13 , 33 ] and other parts of the globe, especially low- and middle-income countries [ 34 ], have also shown similar patterns.…”

Factors Influencing Health Facility Delivery in Predominantly Rural Communities across the Three Ecological Zones in Ghana: A Cross-Sectional Study

“…Messages from healthcare providers should therefore be packaged to convey succinct information on the importance of health facility delivery. Further, as observed in the study, high ANC attendance [ 5 , 42 ] provides an opportunity for healthcare providers to educate on the benefits of health facility delivery to pregnant women.…”

Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review

“…109 Among pregnant women, the prevalence of concurrent use was lower in Kenya (20%) 89 than Uganda (64.1%) 91 and Ghana (45%). 172 Among the general outpatients, two studies in Nigeria reported a varied prevalence of 21% 153 and 69.4%. 165 sociodemographic profile of TCAM users in the general population The sociodemographic characteristics of users of TCAM were identified in a number of articles.…”