Using the Health Belief Model to explore rural maternal utilisation of skilled health personnel for childbirth delivery: a qualitative study in three districts of the Eastern Region of Ghana

Abstract

BackgroundAlthough maternal mortality has decreased substantially since the 1990s, it remains one of the top priorities in global health, as most deaths can be prevented if women have access to and utilise skilled health personnel for childbirth delivery. While efforts have been made to increase the supply and accessibility of services, the lack of maternal utilisation of skilled health delivery services is a contributing cause of death, particularly among mothers from rural areas. MethodsWe conducted interviews in December 2019 in the Eastern Region of Ghana, with 24 rural mothers who had given birth within the past two years, 12 women who had and 12 women who had not given birth utilising skilled health personnel. ResultsThe main differences between women who did and did not use skilled health personnel for delivery were for Health Belief Model constructs of perceived risk, self-efficacy, and cues to action. Most women who delivered with skilled health personnel believed they were susceptible to complications during childbirth, reported high perceived self-efficacy to overcome barriers to deliver with skilled health personnel, and planned and prepared in advance to deliver with skilled health personnel. In contrast, women who did not deliver with skilled health personnel were less likely to believe in susceptibility to complications, reported low perceived self-efficacy to overcome barriers, and had not planned or prepared in advance for skilled health delivery.Nelson JR, Gren LH, Dickerson TT, et al. Using the Health Belief Model to explore rural maternal utilisation of skilled health personnel for childbirth delivery: a qualitative study in three districts of the Eastern Region of Ghana.

Predicting maternal healthcare seeking behaviour in Afghanistan: exploring sociodemographic factors and women’s knowledge of severity of illness

“…The demographic, socioeconomic, and cultural variables (e.g., age, race, ethnicity, education, income) can influence behavior [ 51 ]. In a study, which employed the HBM’s constructs of perceived risk, self-efficacy, and cues to action, the likelihood of SBA deliveries among Ghanaian women was examined [ 52 ]. The authors reported that women whose deliveries were conducted by SBAs believed that they were prone to complications during childbirth, had high perceived self-efficacy to overcome barriers to deliver with SBAs, and were well-prepared to deliver with SBAs.…”

“…The authors reported that women whose deliveries were conducted by SBAs believed that they were prone to complications during childbirth, had high perceived self-efficacy to overcome barriers to deliver with SBAs, and were well-prepared to deliver with SBAs. In contrast, women who did not deliver with SBAs were less likely to believe in susceptibility to complications, had low perceived self-efficacy to overcome barriers, and were not prepared to deliver with SBAs in advance [ 52 ]. In our study it was found that women whose latest delivery was conducted by SBAs were more likely to seek ≥ 4 ANC, ≥ 4 PNC visits when compared with women whose latest delivery was not conducted by SBAs, and this suggests that these women were awareness of their susceptibility to complications and were preparing in advance during pregnancy to deliver with SBAs.…”

Women’s knowledge of perceived severity of illness predicting healthcare seeking behaviour for antenatal, postnatal care, and institutional delivery services. Findings from a National Survey in Afghanistan

“…The demographic, socioeconomic, and cultural variables (e.g., age, race, ethnicity, education, income) can in uence the behaviour (30). In a study, which employed the HBM's constructs of perceived risk, self-e cacy, and cues to action, the likelihood of SBA deliveries among Ghanaian women was examined (31). The authors reported that women whose deliveries were conducted by SBAs believed that they were prone to complications during childbirth, had high perceived self-e cacy to overcome barriers to deliver with SBAs, and were well-prepared to deliver with SBAs.…”

“…The authors reported that women whose deliveries were conducted by SBAs believed that they were prone to complications during childbirth, had high perceived self-e cacy to overcome barriers to deliver with SBAs, and were well-prepared to deliver with SBAs. In contrast, women who did not deliver with SBAs were less likely to believe in susceptibility to complications, had low perceived self-e cacy to overcome barriers, and were not prepared to deliver with SBAs in advance (31). Using the HBM, a study in Nigeria found that women's perceived susceptibility to complications during pregnancy and childbirth, including pre-eclampsia and eclampsia, in uences healthcare seeking behaviour (32).…”