Implementation challenges of maternal health care in Ghana: the case of health care providers in the Tamale Metropolis

Abstract

BackgroundAchieving the Millennium Development Goal (MDG) of improving maternal health has become a focus in recent times for the majority of countries in sub-Saharan Africa. Ghana’s maternal mortality is still high indicating that there are challenges in the provision of quality maternal health care at the facility level. This study examined the implementation challenges of maternal health care services in the Tamale Metropolis of Ghana.MethodsPurposive sampling was used to select study participants and qualitative strategies, including in-depth interviews, focus group discussions and review of documents employed for data collection. The study participants included midwives (24) and health managers (4) at the facility level.ResultsThe study revealed inadequate in-service training, limited knowledge of health policies by midwives, increased workload, risks of infection, low motivation, inadequate labour wards, problems with transportation, and difficulties in following the procurement act, among others as some of the challenges confronting the successful implementation of the MDGs targeting maternal and child health in the Tamale Metropolis.ConclusionsImplementation of maternal health interventions should take into consideration the environment or the context under which the interventions are implemented by health care providers to ensure they are successful. The study recommends involving midwives in the health policy development process to secure their support and commitment towards successful implementation of maternal health interventions.

Managing hypertensive disorders during pregnancy in low resource settings

“…Though most midwives indicated that they were provided with enough knowledge to manage pre-eclampsia, without a blood pressure machine, management will be poor. These results were supported by various authors, who indicated that a shortage of equipment may impede the management offered by midwives (8,24). There will also be a delay in the diagnosis of hypertension, which might lead to increased maternal mortality rate.…”

“…When the women experience signs of eclampsia, they should be given anti-eclamptic drugs, to prevent repeated episodes of eclampsia and anti-hypertensive drugs, and be turned on the side and transferred to the hospital (7). However, midwives are faced with challenges such as shortage of resources (both human and material) such as equipment and hypertensive drugs and lack of transport, when in need of transferring the women to the next level (8). Other researchers have found that ambulances were not utilized appropriately when there was a need to transfer a pregnant women; the ambulances were not available (9).…”

Stakeholders' views on maternity care shortcomings in rural Ghana: An ethnographic study among women, providers, public, and quasiprivate policy sector actors

“…Earlier studies in Ghana investigated policy bottlenecks and priority settings for improving safe motherhood interventions . Other studies assessed the drivers of maternity service use, while others analyzed the views of district level health providers and decision makers on determinants of maternity service use . Few recent studies in rural northern Ghana assessed family relations and health provider's perspectives of use barriers for maternity care .…”

“…[6][7][8][9] Other studies assessed the drivers of maternity service use, 4,10,11 while others analyzed the views of district level health providers and decision makers on determinants of maternity service use. 2,12,13 Few recent studies in rural northern Ghana assessed family relations and health provider's perspectives of use barriers for maternity care. 10,14,15 None of these studies examined maternity care shortcomings along multiple districts and stakeholder groups in rural Ghana.…”

Unmet reproductive health care needs among rural Ghanaian women

“…Other studies assessed the drivers of maternity service utilization (d ' Ambruoso, Abbey, & Hussein, 2005;Yakong, Rush, Bassett-Smith, Bottorff, & Robinson, 2010), whiles others analyzed the views of district level health providers and decision-makers on determinants of maternity service utilization (Banchani & Tenkorang, 2014;Ganle, 2014;Witter, Garshong, & Ridde, 2013). Few recent studies in rural 68 Chapter 4 northern Ghana assessed family relations and health provider's perspectives of utilization barriers for maternity care Yakong et al, 2010).…”