Women's access to health care in Ghana: Effects of education, residence, lineage and self‐determination

Boateng, John Kwame; Flanagan, Constance A.

doi:10.1080/19485565.2008.9989132

Cited by 10 publications

(8 citation statements)

References 16 publications

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“…Another Ghanaian study highlighted the role and level of education as a significant predictor of physical access [77]. Lack of education was shown to dramatically reduce the probability of using maternal and child health services due to a lack of health-related information among the less educated [44].…”

Section: Resultsmentioning

confidence: 99%

Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level

O’Connell

Bedford

Thiede³

et al. 2015

Int J Equity Health

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IntroductionA key element of the global drive to universal health coverage is ensuring access to needed health services for everyone, and to pursue this goal in an equitable way. This requires concerted efforts to reduce disparities in access through understanding and acting on barriers facing communities with the lowest utilisation levels. Financial barriers dominate the empirical literature on health service access. Unless the full range of access barriers are investigated, efforts to promote equitable access to health care are unlikely to succeed. This paper therefore focuses on exploring the nature and extent of non-financial access barriers.MethodsWe draw upon two structured literature reviews on barriers to access and utilization of maternal, newborn and child health services in Ghana, Bangladesh, Vietnam and Rwanda. One review analyses access barriers identified in published literature using qualitative research methods; the other in published literature using quantitative analysis of household survey data. We then synthesised the key qualitative and quantitative findings through a conjoint iterative analysis.ResultsFive dominant themes on non-financial access barriers were identified: ethnicity; religion; physical accessibility; decision-making, gender and autonomy; and knowledge, information and education. The analysis highlighted that non-financial factors pose considerable barriers to access, many of which relate to the acceptability dimension of access and are challenging to address. Another key finding is that quantitative research methods, while yielding important findings, are inadequate for understanding non-financial access barriers in sufficient detail to develop effective responses. Qualitative research is critical in filling this gap. The analysis also indicates that the nature of non-financial access barriers vary considerably, not only between countries but also between different communities within individual countries.ConclusionsTo adequately understand access barriers as a basis for developing effective strategies to address them, mixed-methods approaches are required. From an equity perspective, communities with the lowest utilisation levels should be prioritised and the access barriers specific to that community identified. It is, therefore, critical to develop approaches that can be used at the district level to diagnose and act upon access barriers if we are to pursue an equitable path to universal health coverage.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-015-0181-z) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level

O’Connell

Bedford

Thiede³

et al. 2015

Int J Equity Health

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“…One female group and one male group discussion were conducted in each area, so in total 16 females and 16 males participated in the discussion. Male and female groups were chosen due to existing gender inequalities in traditional Ghanaian communities [26,27]. Therefore it was expected that participants would be more open and feel more at ease to express their opinions and experiences in homogenous groups [28,29].…”

Section: Methodsmentioning

confidence: 99%

Former Buruli Ulcer Patients’ Experiences and Wishes May Serve as a Guide to Further Improve Buruli Ulcer Management

et al. 2016

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BackgroundBuruli ulcer (BU), caused by Mycobacterium ulcerans, is a neglected tropical disease frequently leading to permanent disabilities. The ulcers are treated with rifampicin and streptomycin, wound care and, if necessary surgical intervention. Professionals have exclusively shaped the research agenda concerning management and control, while patients’ perspective on priorities and preferences have not explicitly been explored or addressed.Methodology/Principal findingsTo get insight into patient perception of the management and control of Buruli ulcer a mixed methods research design was applied with a questionnaire and focus group discussions among former BU patients. Data collection was obtained in collaboration with a local team of native speakers in Ghana. A questionnaire was completed by 60 former patients and four focus group discussions were conducted with eight participants per group. Former patients positively evaluated both the effectiveness of the treatment and the financial contribution received for the travel costs to the hospitals. Pain experienced during treatment procedures, in particular wound care and the streptomycin injections, and the side-effects of the treatment were negatively evaluated. Former patients considered the development of preventive measures and knowledge on the transmission as priorities. Additionally, former patients asked for improved accessibility of health services, counselling and economic support.ConclusionsThese findings can be used to improve clinical management and to guide the international research agenda.

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“…There is no question on the DHS to identify lineage. However, several studies have noted that in Ghana, ethnic identity is an important proxy to identify lineage (Boateng & Flanagan, 2008; Takyi & Dodoo, 2005; Takyi, 2001; Takyi & Broughton, 2006). The study, therefore, employs ethnicity to identity lineage in Ghana, and to determine the associations between lineage and IPPV.…”

Section: Methodsmentioning

confidence: 99%

“…If women perceive that there are few alternatives to their marriage, they would be more tolerant of an abusive husband (Kalmuss & Straus, 1982;Yount, 2005). Matrilineal women also receive more rights and benefits from their maternal family than from their husbands (Boateng & Flanagan, 2008;Takyi & Broughton, 2006;Takyi & Dodoo, 2005;Takyi & Gyimah, 2007). Women with closer ties to biological kin may have more control over finances and decision-making power (Moors, 1995;Morsy, 1993).…”

Section: Introductionmentioning

confidence: 99%

“…The literature on IPV among Ghanaian women is however nascent. Also, although several studies on Ghana have emphasized the central role played by lineage ties in family life (e.g., Takyi & Broughton, 2006; Takyi & Gyimah, 2007); in fertility issues (Caldwell, 1982; Caldwell & Caldwell, 1987; DeRose, 2002; Dodoo & Tempenis, 2009; Page, 1989; Takyi & Dodoo, 2005) and access to health care (Boateng & Flanagan, 2008), the relationship between lineage ties and IPV has generally been overlooked. This article aims to address the gap in the literature utilizing data from the 2008 population-based Demographic and Health Survey (DHS) to analyze the relationship between lineage ties and intimate partner physical violence (IPPV).…”

Section: Introductionmentioning

confidence: 99%

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Lineage Ties and Domestic Violence in Ghana

Asiedu

2016

Journal of Family Issues

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Although studies have revealed that there are numerous confounding factors affecting intimate partner violence in non-Western societies, the relevance of lineage ties has been overlooked. This article focuses on intimate partner physical violence (IPPV). Specifically, it employs data from the 2008 Demographic and Health Survey to examine the relationship between lineage groups and IPPV in Ghana. Data analyses reveal that married women who belong to patrilineal groups are more likely to experience IPPV, even after controlling for important sociodemographic factors, such as educational status and area of residence. Specifically, the probit regressions show that all else equal, the probability of experiencing IPPV is about 5 percentage points higher for women from patrilineal societies than for women from matrilineal societies. The logit regressions reveal that women from patrilineal societies are about 1.4 times more likely to experience IPPV than women from matrilineal societies. This research contributes to the scarce literature on the nature of domestic violence among women in sub-Saharan Africa.

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Women's access to health care in Ghana: Effects of education, residence, lineage and self‐determination

Cited by 10 publications

References 16 publications

Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level

Synthesizing qualitative and quantitative evidence on non-financial access barriers: implications for assessment at the district level

Former Buruli Ulcer Patients’ Experiences and Wishes May Serve as a Guide to Further Improve Buruli Ulcer Management

Lineage Ties and Domestic Violence in Ghana

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