Social costs of skilled attendance at birth in rural Ghana

Bazzano, Alessandra N.; Kirkwood, Betty; Tawiah-Agyemang, Charlotte; Owusu‐Agyei, Seth; Adongo, Philip Baba

doi:10.1016/j.ijgo.2008.02.004

Cited by 53 publications

(71 citation statements)

References 13 publications

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“…Women may also be persuaded to deliver at home by important social preferences and pressures and by diminishing concern about the risks of childbirth with increased parity [25]. Across Africa, TBAs have built strong roots that are both socially and culturally based [22].…”

Section: Discussionmentioning

confidence: 99%

“…Researchers have documented that women value TBAs' social skills, patience, and respect, and the additional services that TBAs provide such as cooking, cleaning, and washing [11]. Other studies examining sociocultural reasons for continued high rates of home delivery point to factors such as the relative privacy afforded by home delivery, higher social status gained from not needing birth assistance, and fear of surgical delivery [25,26].…”

Section: Discussionmentioning

confidence: 99%

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Dissatisfaction with traditional birth attendants in rural Tanzania

Mbaruku

Msambichaka

Galea

et al. 2009

Intl J Gynecology & Obste

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dissatisfaction with traditional birth attendants in rural Tanzania

Mbaruku

Msambichaka

Galea

et al. 2009

Intl J Gynecology & Obste

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“…Studies in Ethiopia, Gambia, Ghana, India, Nigeria, Swaziland, Tanzania and Tunisia all indicate that women of childbearing age often do not decide whether or not to seek healthcare. Instead, these decisions are made on their behalf by their spouse or a senior member of their family such as their mother-in-law, father-in-law or compound head (Bazzano, Kirkwood, Tawiah-Agyemang, Owusu-Agyei, & Adongo, 2008;Jansen, 2006;Magoma et al, 2010;Mills & Bertrand, 2005;Moyer et al, 2013;Thaddeus & Maine, 1994).…”

Section: Introductionmentioning

confidence: 99%

Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana

Gupta

Aborigo

Adongo

et al. 2015

Global Public Health

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Previous research suggests that care-seeking in rural northern Ghana is often governed by a woman's husband or compound head. This study was designed to explore the role grandmothers (typically a woman's mother-in-law) play in influencing maternal and newborn healthcare decisions. In-depth interviews were conducted with 35 mothers of newborns, 8 traditional birth attendants and local healers, 16 community leaders and 13 healthcare practitioners. An additional 18 focus groups were conducted with stakeholders such as household heads, compound leaders and grandmothers. In this region, grandmothers play many roles. They may act as primary support providers to pregnant mothers, care for newborns following delivery, preserve cultural traditions and serve as repositories of knowledge on local medicine. Grandmothers may also serve as gatekeepers for health-seeking behaviour, especially with regard to their daughters and daughters-in-law. This research also sheds light on the potential gap between health education campaigns that target mothers as autonomous decision-makers, and the reality of a more collectivist community structure in which mothers rarely make such decisions without the support of other community members.

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“…However, even in settings where these services are available, women with low socio-economic status, minimal education, and with residence in rural areas fail to access them. Reasons for this include high direct and indirect costs of healthcare, lack of transportation, long distances to health facilities, inadequate information about services provided, and negative past experiences with health care providers [19–21]. Socio-cultural vulnerabilities also play a role in inhibiting women’s use of skilled care at birth.…”

Section: Introductionmentioning

confidence: 99%

Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988 – 2008

Asamoah

Agardh

Pettersson

et al. 2014

BMC Pregnancy Childbirth

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BackgroundImproving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth. This study therefore aimed at investigating the magnitude and trends in income-, education-, residence-, and parity-related inequalities in access to antenatal care and skilled attendance at birth.MethodsA database was constructed using data from the Ghana Demographic and Health Surveys (DHS) 1988, 1993, 1998, 2003, and 2008. The surveys employed standard DHS questionnaires and techniques for data collection. We applied regression-based Total Attributable Fraction (TAF) as an index for measuring socioeconomic inequalities in antenatal care and skilled birth attendance utilization.ResultsThe rural–urban gap and education-related inequalities in the utilization of antenatal care and skilled birth attendants seem to be closing over time, while income- and parity-related inequalities in the use of antenatal care are on a sharp rise. Income inequality regarding the utilization of skilled birth attendance was rather low and stable from 1988 to 1998, increased sharply to a peak between 1998 and 2003, and then leveled-off after 2003.ConclusionsThe increased income-related inequalities seen in the use of antenatal care and skilled birth attendance should be addressed through appropriate strategies. Intensifying community-based health education through media and door-to-door campaigns could further reduce the mentioned education- and parity-related inequalities. Women should be highly motivated and incentivized to attend school up to secondary level or higher. Education on the use of maternal health services should be integrated into basic schools so that women at the lowest level would be inoculated with the appropriate health messages.

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Social costs of skilled attendance at birth in rural Ghana

Abstract: The social costs of obtaining skilled attendance at birth must be offset by community level strategies such as mobilization of older women and husbands, and ensuring health providers extend professional, humane care to laboring women.

Cited by 53 publications

References 13 publications

Dissatisfaction with traditional birth attendants in rural Tanzania

Dissatisfaction with traditional birth attendants in rural Tanzania

Grandmothers as gatekeepers? The role of grandmothers in influencing health-seeking for mothers and newborns in rural northern Ghana

Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988 – 2008

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